In vacuum-assisted delivery, the 'chignon' (caput succedaneum under the cup) is an expected finding. The most serious complication specific to vacuum extraction (not seen with forceps) is:

• A Cephalhaematoma
• B Subgaleal (subaponeurotic) haemorrhage ✓
• C Facial nerve palsy
• D Erb's palsy

Explanation

Subgaleal (subaponeurotic) haemorrhage is the most serious complication of vacuum extraction, as the potential space between the galea aponeurotica and the periosteum can accommodate the entire neonatal blood volume (70–80 mL/kg). It presents as a fluctuant, spreading scalp swelling crossing suture lines (unlike cephalhaematoma which is limited by sutures). It can cause hypovolaemic shock and carries ~25% mortality if unrecognised. Facial nerve palsy is associated with forceps (not vacuum). Cephalhaematoma can occur with both but is not life-threatening.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.