After the uterine incision and membranes rupture,
the vacuum cup was placed over the occiput. When
the previously applied clamp was removed, the suction
was immediately available, and the vacuum cup
becomes attached to the head. Fifteen seconds after,
we applied traction concurrently with gentle fundal
pressure, pulling towards the middle of the uterine
incision. Holding the instrument near the base of the
vacuum cup, and gentle fundal pressure was helpful
for completion of the procedure. Following delivery
of the head, the vacuum was discontinued, and the
cup removed.