Which of the following conditions is a contraindication to vacuum-assisted vaginal delivery but NOT to forceps delivery?
- A Occipitoposterior position at +2 station
- B Gestational age of 32 weeks ✓
- C Suspected fetal coagulopathy
- D Unengaged presenting part
Explanation
Vacuum extraction is avoided below 34 weeks of gestation because the fragile preterm scalp and germinal matrix predispose to subgaleal and intraventricular haemorrhage; forceps remain acceptable at this gestation. Suspected fetal coagulopathy and a recent attempt at fetal scalp blood sampling also contraindicate vacuum specifically, while malposition such as occipitoposterior and an engaged head are acceptable for either instrument. An unengaged head contraindicates both instruments, making C tempting but B equally valid, so the single best answer keyed here is the preterm fetus, the classic examined discriminator.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.