[Comparison vacuum extractor versus forceps].

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Surgical Instruments

Background:

• Obstetrical interventions like forceps and vacuum extraction are crucial for managing childbirth complications.
• Objective criteria are needed to guide the selection between these two common instruments.

Purpose of the Study:

• To compare obstetrical forceps and vacuum extractors based on their advantages, disadvantages, and specific complications.
• To identify objective criteria for choosing between forceps and vacuum extraction in clinical practice.

Main Methods:

• A Medline literature search was conducted to review comparative studies.
• Evidence levels (II-1, II-2, III) were considered for evaluating outcomes.

Main Results:

• Vacuum extraction is widely used, with quicker learning curves but longer extraction times than forceps.
• Forceps demonstrate higher success rates, particularly in cases of prematurity and complete anesthesia.
• Maternal complications are less frequent with vacuum extraction, while neonatal risks like cephalhematomas are higher.
• Neonatal complications such as facial nerve paralysis and skull fractures are more common with forceps.

Conclusions:

• The choice between forceps and vacuum extraction depends on specific clinical scenarios, including fetal presentation, anesthesia availability, and prematurity.
• Both methods have comparable long-term effects on maternal pelvic floor function but increased anal incontinence with forceps.
• While immediate neonatal morbidities are similar, specific risks are associated with each instrument, necessitating careful consideration.