Forceps or vacuum delivery should only be performed if there are clear indications and no contraindications.
Patient selection: vaginal birth
Indications:
(1) prolonged second stage of labor (see below)
(2) shortening of the second stage of labor for maternal benefit (maternal exhaustion)
(3) suspicion of immediate or potential fetal compromise with the vertex below the ischial spines
where:
• There is adequate maternal pushing and there are uterine contractions.
Prolonged Second Stage
Without Regional Anesthesia
With Regional Anesthesia
Nulliparous
> 3 hours
> 4 hours
Multiparous
> 2 hours
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Specialty: Obstetrics & Gynecology
