Vacuum-assisted vaginal delivery.

The second stage of labor is a dynamic event that may require assistance when maternal efforts fail to effect delivery or when there are nonreassuring fetal heart tones. Therefore, knowing how to perform an operative vaginal delivery with forceps or vacuum is vital for family physicians who provide maternity care. Vacuum is rapidly replacing forceps as the predominant instrument, but each has advantages and disadvantages, including increased risk of maternal trauma with forceps and increased risk of neonatal cephalohematoma with vacuum.

The Advanced Life Support in Obstetrics (ALSO) program: fourteen years of progress.

Background: The Advanced Life Support in Obstetrics (ALSO) program is a highly structured, evidence-based, two-day course designed to provide healthcare professionals with the knowledge and skills to manage the emergency conditions that can occur during childbirth.

Objectives: To document the number of ALSO-trained clinicians and instructors in the United States and internationally and to promote ALSO training among prehospital and disaster medicine professionals.

Methods: Records maintained by the American Academy of Family Physicians (AAFP) for each country where ALSO is taught were reviewed for: (1) the years and locations of the ALSO courses; (2) the number of ALSO-trained caregivers; and (3) the number of ALSO instructors.