Vacuum extraction is being applied to deliver a fetus in occiput posterior (OP) position at +2 station. Which of the following complications is MOST specifically associated with vacuum delivery compared to forceps delivery?
- A Subgaleal (subaponeurotic) hemorrhage ✓
- B Facial nerve palsy
- C Maternal perineal lacerations (3rd/4th degree)
- D Cephalhematoma without intracranial hemorrhage
Correct answer: A. Subgaleal (subaponeurotic) hemorrhage
Explanation
Subgaleal hemorrhage (hemorrhage into the subaponeurotic space between the galea aponeurotica and the periosteum) is the most serious neonatal complication specifically associated with vacuum extraction, not forceps. Blood can accumulate in a large potential space causing hypovolemic shock. Cephalhematoma is also more common with vacuum. Facial nerve palsy and maternal perineal lacerations are more associated with forceps delivery due to blade compression of the facial nerve and perineal trauma from the blade application.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.