A vacuum delivery attempt fails after three pop-offs. The clinician should next:
- A Apply forceps immediately for assisted delivery
- B Proceed to cesarean section ✓
- C Reapply vacuum with a larger cup
- D Administer oxytocin and allow more time for descent
Correct answer: B. Proceed to cesarean section
Explanation
Three cup detachments (pop-offs) during a vacuum delivery attempt is an absolute indication to abandon the procedure and proceed to cesarean section. Sequential instrumental delivery (using forceps after failed vacuum) significantly increases the risk of neonatal morbidity including intracranial hemorrhage and is generally not recommended. Reapplication of vacuum after three detachments is contraindicated.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.