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胎头吸引阴道助产的操作

Author
James Greenberg, MD
Section Editor
Charles J Lockwood, MD, MHCM
Deputy Editor
Vanessa A Barss, MD, FACOG
Translators
于红, 主任医师，副教授

引言

1953年，瑞典产科医生Tage Malmström对一种中空的圆盘形不锈钢金属杯用于胎头吸引助产进行了介绍[1]。吸引管与圆盘形金属杯的圆顶部相连，一根牵引链从管中穿过。Malmström杯迅速成为之后所有负压吸引器系统的模板[2,3]。

至20世纪70年代，在北欧国家负压吸引器助产基本上取代了产钳助产。然而，在许多说英语的国家(包括美国和英国)，对负压设备的接纳相对较慢[2]。尽管如此，至1992年，在美国胎头吸引助产的数量超过了产钳助产的数量；至2000年，约2/3的阴道助产均是通过负压吸引进行的[4]。

本文将总结胎头吸引助产的技术。阴道助产方法的相关概述(包括风险和结局)可参见其他专题。 (参见“Operative vaginal delivery”)

指征和禁忌证

指征 — 只有当存在特定产科指征时，才可尝试进行胎头吸引助产[5,6]。三大类指征包括：第二产程延长、胎儿宫内状态不佳、母体存在心脏病或神经系统疾病；但不存在绝对指征。

阴道助产的适应证和先决条件将单独详细讨论。 (参见“Operative vaginal delivery”, section on ‘Indications’和“Operative vaginal delivery”, section on ‘Prerequisites’)

                         

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Literature review current through: 2017-06 . | This topic last updated: 2016-12-20.
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References
Top
  1. Malmström, T. The vacuum extractor: An obstetrical instrument. Acta Obstet Gyncol Scand 1957; 36:5.
  2. Miksovsky P, Watson WJ. Obstetric vacuum extraction: state of the art in the new millennium. Obstet Gynecol Surv 2001; 56:736.
  3. Vacca, A. Vacuum-assisted delivery. OBG Manag 2004; Suppl:S1-7.
  4. Demissie K, Rhoads GG, Smulian JC, et al. Operative vaginal delivery and neonatal and infant adverse outcomes: population based retrospective analysis. BMJ 2004; 329:24.
  5. FDA Public Health Advisory. Need for caution when using vacuum assisted delivery devices. U.S. Food and Drug Administration: Center for Devices and Radiological Health: www.fda.gov/cdrh/fetal598.html.
  6. Johanson, RB. Instrumental vaginal delivery. Guidelines and Audit Committee of the Royal College of Obstetricians and Gynaecologists, 2001.
  7. Attilakos G, Sibanda T, Winter C, et al. A randomised controlled trial of a new handheld vacuum extraction device. BJOG 2005; 112:1510.
  8. Groom KM, Jones BA, Miller N, Paterson-Brown S. A prospective randomised controlled trial of the Kiwi Omnicup versus conventional ventouse cups for vacuum-assisted vaginal delivery. BJOG 2006; 113:183.
  9. Ismail NA, Saharan WS, Zaleha MA, et al. Kiwi Omnicup versus Malmstrom metal cup in vacuum assisted delivery: a randomized comparative trial. J Obstet Gynaecol Res 2008; 34:350.
  10. Johanson R, Menon V. Soft versus rigid vacuum extractor cups for assisted vaginal delivery. Cochrane Database Syst Rev 2000; :CD000446.
  11. Muise KL, Duchon MA, Brown RH. The effect of artificial caput on performance of vacuum extractors. Obstet Gynecol 1993; 81:170.
  12. Hofmeyr GJ, Gobetz L, Sonnendecker EW, Turner MJ. New design rigid and soft vacuum extractor cups: a preliminary comparison of traction forces. Br J Obstet Gynaecol 1990; 97:681.
  13. Hammarström M, Csemiczky G, Belfrage P. Comparison between the conventional Malmström extractor and a new extractor with Silastic cup. Acta Obstet Gynecol Scand 1986; 65:791.
  14. Ross MG, Fresquez M, El-Haddad MA. Impact of FDA advisory on reported vacuum-assisted delivery and morbidity. J Matern Fetal Med 2000; 9:321.
  15. Billings, RG. The physics of vacuum extraction. OBG Manag 2004; Suppl S7.
  16. Suwannachat B, Lumbiganon P, Laopaiboon M. Rapid versus stepwise negative pressure application for vacuum extraction assisted vaginal delivery. Cochrane Database Syst Rev 2012; :CD006636.
  17. Duchon MA, DeMund MA, Brown RH. Laboratory comparison of modern vacuum extractors. Obstet Gynecol 1988; 71:155.
  18. MISHELL D Jr, KELLY JV. The obstetrical forceps and the vacuum extractor: an assessment of their compressive force. Obstet Gynecol 1962; 19:204.
  19. Moolgaoker AS, Ahamed SO, Payne PR. A comparison of different methods of instrumental delivery based on electronic measurements of compression and traction. Obstet Gynecol 1979; 54:299.
  20. Laufe LE. Divergent and crossed obstetric forceps. Comparative study of compression and traction forces. Obstet Gynecol 1971; 38:885.
  21. Vacca A. Vacuum-assisted delivery: an analysis of traction force and maternal and neonatal outcomes. Aust N Z J Obstet Gynaecol 2006; 46:124.
  22. Baskett TF, Fanning CA, Young DC. A prospective observational study of 1000 vacuum assisted deliveries with the OmniCup device. J Obstet Gynaecol Can 2008; 30:573.
  23. Vacca A. Handbook of vacuum assisted delivery in obstetric practice, 2nd ed, Vacca Research, Brisbane, Australia 2003.
  24. Bofill JA, Rust OA, Schorr SJ, et al. A randomized trial of two vacuum extraction techniques. Obstet Gynecol 1997; 89:758.
  25. Kudish B, Blackwell S, Mcneeley SG, et al. Operative vaginal delivery and midline episiotomy: a bad combination for the perineum. Am J Obstet Gynecol 2006; 195:749.
  26. Johanson RB, Rice C, Doyle M, et al. A randomised prospective study comparing the new vacuum extractor policy with forceps delivery. Br J Obstet Gynaecol 1993; 100:524.
  27. Bofill JA, Rust OA, Devidas M, et al. Neonatal cephalohematoma from vacuum extraction. J Reprod Med 1997; 42:565.
  28. Teng FY, Sayre JW. Vacuum extraction: does duration predict scalp injury? Obstet Gynecol 1997; 89:281.
  29. Bird GC. The importance of flexion in vacuum extractor delivery. Br J Obstet Gynaecol 1976; 83:194.
  30. Sadan O, Ginath S, Gomel A, et al. What to do after a failed attempt of vacuum delivery? Eur J Obstet Gynecol Reprod Biol 2003; 107:151.
  31. Towner D, Castro MA, Eby-Wilkens E, Gilbert WM. Effect of mode of delivery in nulliparous women on neonatal intracranial injury. N Engl J Med 1999; 341:1709.
  32. Revah A, Ezra Y, Farine D, Ritchie K. Failed trial of vacuum or forceps--maternal and fetal outcome. Am J Obstet Gynecol 1997; 176:200.