**7.2 Contraindications**

The following are contraindications to the performance of operative vaginal deliveries.


Facility-based studies from several countries show that indications for operative vaginal delivery procedure fall easily within these categories. Indications for vacuum and forceps

> 61 (61) 10 (16.4) 20 (32.8) 9 (9) 0 (0) 0 (0) 100 (100)

26 (50) 14 (26.9) 11 (21.1) 1 (1.9) 52 (100)

69 (21.5) 161 (49) 83 (26) 11 (3.5) 324 (100)




The following are contraindications to the performance of operative vaginal deliveries.


Table 5. Indications for vacuum and forceps delivery in health care facilities

having only a pelvic curve but no cephalic curve.

used to deliver a 'floating' fetal head.


delivery of an impacted fetal head.

**Vacuum Forceps** 

61 (41.9) 18 (12.3) 51 (34.9) 12 (8.2) 3 (2.1) 1 (0.6) 146 (100)

12 (37.5) 10 (31.3) 10 (31.3) 0 (0.0) 32 (100)

9 (18) 22 (44) 16 (32) 3 (6) 50 (100)

delivery in 3 large hospitals in 3 countries are shown in table 5 below.

Nigeria (Zaria)

Maternal distress

Fetal compromise Fetal prematurity Obstructed labour

Cameroon (Yaounde) Prolonged 2nd stage Excessive fetal weight Acute fetal distress

Greece (Thessaloniki) Prolonged 2nd stage Maternal exhaustion Non re-assuring fetal status

**7.1 Other indications** 

**7.2 Contraindications** 


Mother with cardiomyopathy

Total

Total

Others Total

Delayed 2nd stage of labour

Medical illness; PET/eclampsia


Blood-borne viral infections of the mother e.g HIV are not a contraindication to operative vaginal delivery. However, it is sensible to avoid difficult operative delivery where there is an increased chance of fetal abrasion or scalp trauma and to avoid fetal scalp clips or blood sampling during labour.
