Pediatricians and NICU staff are present at most operative vaginal deliveries per hospital protocol but may not be familiar with the indications for and neonatal implications of an operative-assisted vaginal delivery.

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Operative vaginal deliveries, or vaginal deliveries performed with assistance from either a vacuum device or obstetric forceps, are a safe and effective alternative to a spontaneous vaginal delivery when maternal or fetal indications necessitate an expedited delivery. In many clinical situations, an operative vaginal delivery may reduce maternal and fetal morbidity compared to a cesarean delivery. In the United States, operative vaginal deliveries make up approximately 3% to 5% of all vaginal deliveries. (1) Indications include a wide variety of both maternal and fetal conditions and complications, including maternal cardiac or vascular conditions, maternal exhaustion, or a deteriorating fetal heart tracing. (2)(3) In the...

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