The use of the vacuum extractor at cesarean section has been advocated in order to avoid extension of the uterine incision and to facilitate the delivery of a floating head. We have evaluated, prospectively and retrospectively, the neonatal outcome of vacuum extraction at cesarean section in comparison with regular cesarean section. The interval between the final uterine incision and complete delivery (U-D interval) was significantly prolonged (P less than 0.01) in 8 cases of vacuum extraction (Group A) when prospectively compared with 10 cases of regular cesarean section (Group B). The Apgar scores, the acid-base values at delivery and the clinical course of the two groups were not significantly different. Although analysis of our prospective data suggests a trend of an association between prolongation of the U-D interval and neonatal depression, our retrospective data of 34 neonates delivered by vacuum extraction at cesarean section and 44 neonates delivered by regular cesarean section, showed no significant untoward effect when the vacuum extractor was utilized. Since prolongation of the U-D interval may have an undesireable effect on the fetus, we advocate extra caution in the use of this method.
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