Which condition is an absolute contraindication to the use of vacuum extractor (ventouse) for operative vaginal delivery?
- A Gestational age less than 34 weeks ✓
- B Occiput posterior position
- C Second stage lasting >2 hours
- D Maternal cardiac disease
Correct answer: A. Gestational age less than 34 weeks
Explanation
Vacuum extraction is absolutely contraindicated below 34 weeks gestation due to the high risk of subgaleal (subaponeurotic) haemorrhage and intracranial injury in preterm neonates whose calvaria are more pliable and venous structures more fragile. Occiput posterior, prolonged second stage, and maternal cardiac disease are indications or associated conditions where operative delivery may be beneficial; none are absolute contraindications to ventouse.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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