Checklist before vacuum-assisted vaginal birth

Huddle

Confirm verbal (and/or written) patient consent

Confirm patient has adequate anesthesia and that a member of the anesthesia team is immediately available

Notify neonatology-pediatrics about an assisted vaginal birth

Confirm Nurse-in-Charge is aware

Confirm availability of an operative room and staffing for an urgent cesarean birth, if required

Time out before beginning the assisted vaginal birth in the procedure room

Verbalize the indication for the assisted vaginal birth

Verbalize that the patient is ≥34 weeks of gestation

Verbalize fetal position and station

Verbalize estimated fetal weight

Verbalize stopping rules, for example:

3 pop-offs (or 2 if Kiwi^® per manufacturer's instructions)
Not making progress after 3 sets of pulls in the descent phase
Infant not delivered after 2 sets of pulls when scalp visible through the labia without contractions or traction
30 minutes has transpired from the first pull

Verbalize that delivery is planned by cesarean birth within 60 minutes after starting the assisted vaginal birth if the assisted vaginal birth fails

Due to specific patient needs, some cases may be managed outside the proposed guidelines. These circumstances should be discussed with the clinical team and documented. For additional information, refer to UpToDate content on assisted vaginal birth.

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Checklist before vacuum-assisted vaginal birth