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Assisted Delivery (FIGO)

FIGO Assisted Vaginal Delivery

Standardized Operative Prerequisites

FORCEPS / VENTOUSE Prerequisites

Full Dilation (10cm)

Ruptured Membranes

Engaged Head (Station ≥ 0)

Empty Bladder / Adequate Analgesia

Position Known / Pelvis Adequate

Critical Decision Pathways

ABANDON PROCEDURE IF:

No progressive descent after 3 pulls OR 3 'pop-offs' of ventouse.

Mnemonic: FORCEPS

F: Full Dilation • O: Open Membranes • R: Ruptured Membranes • C: Cephalic • E: Engaged • P: Pelvis • S: Station

Friedman Curve (Reference)

Latent Phase: Para 0 (≤20h), Para 1+ (≤14h). Active Phase: 1.2cm/h (Para 0), 1.5cm/h (Para 1+). *Note: WHO now uses 1cm/h threshold.*

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Primary Clinical Indications

Prolonged second stage of labor (lack of progress despite adequate pushing efforts)

Maternal exhaustion or failure of voluntary expulsive efforts

Medical need to shorten the second stage (e.g., severe maternal cardiac disease, severe hypertension, aneurysmal disease)

Non-reassuring fetal heart rate (FHR) pattern requiring expedited delivery when vaginal birth is imminent

Absolute Contraindications (When NOT to Use)

Do NOT attempt if: fetal head is unengaged, fetal position is unknown, cervix is not fully dilated, or in suspected fetal bleeding/demineralization disorders (e.g., hemophilia, osteogenesis imperfecta). Vacuum extraction is strictly contraindicated in preterm gestations <34 weeks due to massive intraventricular hemorrhage risk.

Last Comprehensive Review: 2026