Objective: To compare a one-step (rapid) application of negative pressure (vacuum) with conventional stepwise application for ventouse extraction following a prolonged second stage of labour.
Design: Randomised controlled study.
Setting: Teaching Hospital.
Participants: Forty-seven women were randomised to the rapid vacuum group and 47 to the stepwise group.
Main outcome measures: Duration of ventouse procedure, effectiveness of methods of application, morbidity of mother and infant.
Results: There was no significant difference in frequency of detachment of the cup after rapid or stepwise application of vacuum. A reduction in mean duration of the ventouse procedure of 6 min was realised without significant difference in maternal or neonatal morbidity.
Conclusion: Rapid application of vacuum significantly reduces the duration of a ventouse extraction procedure without compromise to efficiency and safety.