The use of devices, such as forceps or a vacuum (known as a “ventouse”),
is a common method that doctors use to assist in the process of a difficult
delivery. Generally speaking, forceps and
vacuums are used to grasp an infant’s head when a doctor is having difficulty
delivering the child and help gently remove the baby from the birth canal.
Though both of these devices can be useful in many situations, they are
not without their own very serious risks in the event that they are used
improperly.
Facial bruising and lacerations, facial nerve damage, skull fractures,
and even cerebral palsy and other types of severe brain damage are among
the injuries may occur as a result of the use of forceps or a vacuum,
making it very important for doctors to both understand the risks involved
as well as recognize when the time calls for such measures. Ensuring that
the doctors handling a baby’s life and future well-being know how
to properly use such devices as forceps or vacuums is no small matter,
as studies have indicated that the occurrence of intracranial hemorrhage
is more than three times as likely to occur in instances of vacuum or
forceps-assisted delivery versus spontaneous vaginal delivery or
Caesarian sections with no labor.
One of the greatest risks posed by the use of such devices for a delivery
is that of cerebral palsy, as improperly used forceps or vacuums for delivery
can result in permanent damage being done to the child.
Cerebral palsy frequently occurs in forceps deliveries when the forceps themselves damage
the delicate portion of the brain called the cerebrum, which is instrumental
in controlling motor functions such as movement, sensory processing, and
the development of speech and language use.
How Forceps Can Cause Birth Injury
Many injuries related to the use of forceps result from the improper placement
of the forceps on a child’s head. When improperly placed, forceps
can turn from a helpful medical device to a highly dangerous instrument
that exposes the baby’s soft and vulnerable head to potentially damaging
pressure that can lead to skull injury and even
brain damage such as cerebral palsy at
birth. This extreme cranial pressure can lead to damage to facial nerves as
well as potential fractures to the fetal skull, the latter of which may
result in the damage to the cerebrum necessary to cause cerebral palsy
in an infant.
Studies have shown that facial nerve damage occurs in about 4.5 of every
1,000 forceps assisted deliveries, while skull fracturing is experienced
by about one in every 4,500. Thankfully, many of the injuries to fetal
facial nerves are far less serious than those of fetal skull fractures,
but the occurrences of both are high enough to require that a high degree
of care be taken in the use of forceps so as to avoid any damage to the
delicate fetal skull.
How A Vacuum Can Cause Birth Injury
Similarly to forceps, the use of a vacuum to assist in the delivery process
can be very helpful, but its use also carries with it a high degree of
risk if not performed properly. Though vacuum-assisted deliveries are
becoming more frequent than
forceps deliveries, there is still much debate over which procedure is safer for the health
of a child. The occurrence of subgaleal hematoma, a condition in which
blood collects in the space between an infant’s skull and the scalp,
has been heavily associated with vacuum assisted delivery, with some 90%
of all cases of subgaleal hematoma being linked to the use of a vacuum
during delivery.
This makes vacuum-assisted delivery particularly risky, as this collecting
of blood can result in the
deprivation of oxygen to the brain, potentially giving rise to severe brain damage and cerebral palsy. Vacuum
extraction may also lead to the occurrence of cephalohematoma, another
kind of event in which blood pools next to the baby’s skull. Though
not considered to be as serious as subgaleal hematoma given that the blood
is usually reabsorbed within a period of two weeks to three months, cephalohematoma
presents its own kinds of dangers. The breakdown of the red blood cells
can cause a drastic increase in the presence of bilirubin in the infant,
high levels of which can lead to jaundice and potentially cerebral palsy.
Perhaps the most important thing that doctors can do when using such devices
to assist in the delivery process is both to recognize the proper time
to use such devices as well as understand how to use them properly. Ensuring
that such factors as the degree of cervical dilation, the position of
the fetal head, and the size of the pelvic capacity versus that of the
fetal head are known prior to engaging in the use of either forceps or
a vacuum extractor are critical to ensuring that both are used in a safe
manner for both the mother and the child. The importance of both diligent
doctors and nurses who take extra precautions to ensure their knowledge
of such factors cannot be understated, as this could be the difference
between a healthy child and one with life-altering brain damage such as
cerebral palsy.