At 38 weeks gestation, a woman in active labour has second stage arrest. The fetal head is at station +2, occiput anterior, with adequate maternal effort. An attempt at operative vaginal delivery is made. Which of the following is a CONTRAINDICATION to vacuum-assisted delivery?
- A Fetal head at station +2
- B Gestational age of 34 weeks ✓
- C Suspected fetal macrosomia
- D Occiput anterior position
Correct answer: B. Gestational age of 34 weeks
Explanation
Vacuum-assisted delivery is contraindicated at gestational age less than 34 weeks because the fetal calvarium is not adequately ossified, significantly increasing the risk of subgaleal hematoma and intracranial hemorrhage. Station +2 with occiput anterior and macrosomia are not absolute contraindications, though cephalopelvic disproportion assessment is needed. ACOG guidelines state vacuum should not be used before 34 weeks gestation.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.