The aims of this study were to compare the perinatal outcomes of successful vacuum extraction (VE) or failed VE and to compare the perinatal outcomes of failed VE followed by forceps delivery (FD) or Cesarean section (CS) from 2000 through 2007. Compared with cases of successful VE, cases of failed VE followed by CS had a significantly higher incidence of neonatal complications, whereas cases of failed VE followed by FD had a significantly higher incidence of maternal injury. Both CS and FD remain important yet distinct treatments for emergency cases of failed VE. Therefore, the decision to use a second instrument (FD) or to proceed to CS should be made in each case on the basis of these differences.
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