Objective:To establish standards for the deviation of vacuum cup
placement from the ideal location during operative delivery in
an academic center. Methods:Data on 92 vacuum deliveries were
prospectively obtained. The actual point on the newborns head
was determined and both midline and anterior-posterior line
deviations from the ideal point of placement were calculated.
Results:The most common indication for vacuum extraction was
a nonreassuring fetal heart rate (66.7%). The average deviation on the mid anterior-posterior line was 3.72 ± 1.46 cm; the
average midline-lateral deviation was 1.92 ± 1.33 cm. There
was no statistically significant difference in the cup placement
deviations between deliveries performed by residents and
consultants. The vacuum procedure failed in 8.6% of the cases.
Conclusions: Accurate placement of the vacuum cup on the fetal
head is considered to be clinically important. This assumption
requires scientific clinical proof. Our local standard for deviation
was established and will serve for audit. If safer neonatal and
maternal outcomes are demonstrated, the deviation from the
ideal placement location ought to become a universal quality
measure for vacuum deliveries