The maximum number of 'pulls' (tractions) permitted in a single ventouse application attempt before abandoning the procedure is:

• A Two pop-offs or three tractions
• B Three pop-offs regardless of progress
• C Up to five tractions if progress is being made
• D No more than three tractions with no more than two cup detachments ✓

Explanation

Standard guidelines recommend abandoning ventouse if: (1) there is no progressive descent with each traction, (2) the cup detaches (pops off) more than twice, or (3) delivery is not accomplished within approximately 15–20 minutes or three to four traction efforts. Repeated cup detachments suggest malpresentation or cephalopelvic disproportion, warranting caesarean section. The rule 'three pulls/two pop-offs' reflects the commonly quoted safety threshold.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.