RT Book, Section A1 Shabib, Gihad A1 Black, Amanda A2 Posner, Glenn D. A2 Black, Amanda Y. A2 Jones, Griffith A2 El-Chaâr, Darine SR Print(0) ID 1193312787 T1 Operative Vaginal Birth T2 Oxorn-Foote Human Labor & Birth, 7e YR 2022 FD 2022 PB McGraw-Hill Education PP New York, NY SN 9781260019414 LK obgyn.mhmedical.com/content.aspx?aid=1193312787 RD 2024/10/08 AB Assisted or operative vaginal birth refers to the use of a vacuum or forceps to achieve a vaginal birth in the second stage of labor for fetal or maternal indications. When deciding whether to perform an assisted vaginal birth (AVB), considerations must include indications and contraindications to the procedure, timing and choice of instrument, the maternal or fetal risks of using either instrument, the urgency of the need to expedite delivery, the experience and skills of the birth attendant, and the risks associated with the alternative choice of cesarean section in the second stage of labor. Regardless of the instrument used, the indications for AVB are the same. The operator should assess the safety and likelihood of success by considering the estimated fetal weight, adequacy of the maternal pelvis, fetal station, fetal position, and adequacy of anesthesia prior to use of either forceps or the vacuum. AVB should only be attempted if there is a reasonable chance of success, and a backup plan should be in place in case the attempt is not successful. Forceps or vacuum extraction is contraindicated if the fetal head is not engaged in the pelvis or if the fetal position cannot be determined.