Dr Aldo Vacca's Contribution to Global Women's Health
 

Dr Aldo Vacca 1941 - 2014

The late Dr Aldo Vacca (OAM, MBBS, FRCOG, FRANZCOG, Grad Dip Ed) was renowned as a tireless advocate and educator of vacuum-assisted delivery (VAD), both in Australia and internationally. His efforts are estimated to have avoided 100,000 cases of maternal trauma in Australia alone*. Dr Vacca identified and refined the five steps common to all vacuum deliveries.

Read more about Dr Aldo Vacca 


 

The Vacca 5-Steps

Dr Vacca’s 5-Steps Technique to Vacuum Delivery

Locate the flexion point by identifying the posterior fontanelle with the middle finger and moving the finger along the sagittal suture anteriorly a distance of 3cm to find the flexion point.


STEP 01: Locating the flexion point - Calculating the cup insertion distance


Locate the flexion point by identifying the posterior fontanelle with the middle finger and moving the finger along the sagittal suture anteriorly a distance of 3cm to find the flexion point.


The operator retracts the perineum with two fingers to form a space into which the cup is inserted gently with one movement immediately following a contraction.


STEP 02: Holding the cup - Inserting the cup into the vagina


The operator retracts the perineum with two fingers to form a space into which the cup is inserted gently with one movement immediately following a contraction.


The cup is pushed down the midline of the maternal pelvic axis until the centre of the cup is judged to be over the flexion point (the cup insertion distance).


STEP 03: Manoeuvring the cup towards and over the flexion point


The cup is pushed down the midline of the maternal pelvic axis until the centre of the cup is judged to be over the flexion point (the cup insertion distance).


The recommended vacuum pressure of 60-80kPa (450-600mmHg) should be achieved rapidly. A check for maternal tissue entrapment should always be made.<br/>


STEP 04: Creating the vacuum and excluding maternal tissue entrapment


The recommended vacuum pressure of 60-80kPa (450-600mmHg) should be achieved rapidly. A check for maternal tissue entrapment should always be made.


The 2&2 finger tip and finger thumb technique. Traction for VAD is a two-handed exercise, one hand providing the traction and direction of traction, the other monitoring descent of the head with each pull and controlling the force applied to the fetal head.


STEP 05: Method of traction - Finger tip and finger thumb techniques


The 2&2 finger tip and finger thumb technique. Traction for VAD is a two-handed exercise, one hand providing the traction and direction of traction, the other monitoring descent of the head with each pull and controlling the force applied to the fetal head.


 
 

  Individuals should learn to grade instrumental procedures according to the technical skill that is required and attempt only those vacuum deliveries that fall within their own level of expertise.  

Dr Aldo Vacca Handbook of Vacuum Delivery in Obstetric Practice