An audit of the CaesAid vacuum-assisted delivery cup compared with forceps delivery of the fetal head in caesarean section

Background. Vacuum-assisted caesarean delivery may result in a quicker delivery of the fetal head than the use of forceps, and improve maternal and fetal outcomes. The new CaesAid vacuum-assisted delivery (VAD) cup was designed specifically for this use.  Objectives. To assess whether the CaesAid VAD cup influences the duration of fetal head delivery at caesarean section when compared with forceps, and whether there are differences in perioperative complications in the mother and fetus.  Methods. We carried out a retrospective clinical audit of 132 patients who underwent caesarean delivery at the Netcare Christiaan Barnard Memorial Hospital in Cape Town, South Africa, from April to November 2017, aided by either CaesAid VAD cup (C group, n =67) or forceps (F group, n =65).  Results. The uterine incision-to-delivery interval was significantly shorter ( p =0.001) in the C group than the F group (median 38 (interquartile range (IQR) 20) v. 60 (IQR 50) seconds, respectively). The maternal blood loss was lower in the C group than the F group (250 mL v. 288 mL; p =0.025). There was no significant difference in Apgar scores or admissions to the neonatal intensive care unit. Neonatal skin injuries were less common in the C group (no cases v. 8 in the F group; p =0.004).  Conclusion. The results of this audit suggest that the CaesAid VAD cup is a safe and efficient alternative to forceps for aiding the delivery of the fetal head at caesarean section. However, the routine use of vacuum cups is debatable. Further research could provide more insight into this procedure as a part of obstetric practice.