Indications

The main indications for the obstetrical iCup® vacuum extraction cup are as follows:
The fetal head ceases to progress from the interspinous strait of the pelvis, especially if there is a lack of flexion. In the interspinous strait, the obstetrical vacuum extraction cup seems to be the best instrument to use because it produces flexion. In a cephalic presentation, arrest of the baby's descent in the interspinous strait of the pelvis is very often due to incorrect rotation of a posterior position, and additional flexion makes it possible to turn the baby to an anterior position thus allowing delivery to take place via the vaginal route.
To assist delivery in an exhausted or distressed mother: by accentuating flexion, the obstetric cup makes it easier to get the occiput under the pelvic symphysis
Uterine inertia in addition to oxytocins
Any anomaly of the fetal heart rate (FHR) requiring instrumental extraction
To assist delivery in women with uterine scarring
To assist delivery if the mother is unwell (eclampsia, pre-eclampsia, heart disease, respiratory failure, para- or tetraplegia, cerebral aneurysm, retinopathy  …).

NOTE: Fetal wellbeing and ultrasound estimation of the weight of the fetus must always be taken into account before deciding that extraction is indicated. Any anomalies of heart rate and/or a heavier-than-normal estimated fetal bodyweight should lead to a reconsideration of the indication for fetal extraction based on a risk/benefit calculation.

 

Contraindications

The main contraindications for using the iCup® obstetrical cup are:
Prematurity - less than 34 weeks
Face, breech, brow or transverse (shoulders) presentations
Incomplete dilatation of the cervix
Non-engagement of presentation or presentation in the upper part of the pelvic strait
An indeterminate position
The presence of a large caput succedaneum (a moderate caput succedaneum is often observed after a long labor, and is not a contraindication)
Neonatal hemorrhagic syndromes (hemophilia, in-utero blood clotting disorder, continuous phenobarbital use by the mother)
Fetuses with a bone mineralization defect (incomplete osteogenesis)
Pelvic calluses
Fetopelvic disproportion
Suspected fetal macrosomia
General anesthesia
An un-cooperative mother.
An inexperienced obstetrician

 NB: the presence of a scalp-electrode or micro blood sampling from the scalp are not viewed as being contraindications for the obstetrical cup.