<prompt> Forceps are preferred over vacuum for the delivery because of the following, reasons except?Vacuum requires more clinical skills than forcepsVacuum is preferred more than forceps in HIV patientForceps are more commonly associated with fetal facial injuryVacuum has more chance of formation of cephalhematoma  <response>: Ans. a. Vacuum requires more clinical skills than forceps Ref: Dutta 7e p579, 581Forceps requires more clinical skills than forceps vacuum.Advantages of Ventouse:It is comfortable and has lower rates of maternal trauma and genital tract lacerationsReduced maternal pelvic floor injuries and is advocated as the instrument of the first choicePerineal injuries 3rd and 4th degree tears are lessDue to above mentioned reasons, Vacuum is preferred more than forceps in HIV patient to decrease the transmission. Comparison of Forceps Vs VentouseAdvantages of VentouseAdvantages of Forceps It can be used in the unrotated or malrotated head OP, OT position, it helps in auto rotation It is not a space-occupying device Traction force is less 10 kgQ It is comfortable and has lower rates of maternal trauma and genital tract lacerations Analgesia need is less Reduced maternal pelvic floor injuries and is advocated as the instrument of the first choice Perineal injuries 3rd and 4th degree tears are less Post-partum maternal discomfort pain is less Easier to learn The simplicity of use in delivery makes it convenient to the operator suitable for trained midwives In case, where moderate traction is required, forceps will be more effective Forceps operation can quickly expedite the delivery in case of fetal distress Safer in premature babies Can be employed in the anterior face or after coming head of the breech presentation Lesser neonatal scalp trauma, retinal hemorrhage, jaundice or cephalhematoma The higher rate of successful vaginal delivery Cup detachment pop-off occurs when the vacuum is not maintained in ventouse No. of types of forceps are available for an outlet, mid-cavity or rotational delivery Complications of Forceps OperationMaternal-Fetal Injury: vaginal laceration, sulcus tear, cervical tear, complete perineal tear Nerve injury: Femoral L2, 3, 4, lumbosacral trunk with mid-forceps delivery Post-partum hemorrhage Anesthetic complications Puerperal sepsis and maternal morbidity Remote: Painful perineal scars, dyspareunia, low back ache, genital prolapse, stress urinary incontinence, and anal sphincter dysfunctionImmediate: Asphyxia, facial bruising, intracranial hemorrhage, facial palsy, skull fractures, cervical spine injury rotational forcepsRemote: Cerebral or spastic palsy Complications of Ventouse OperationMaternalFetal Injuries are uncommon Soft tissue such as cervix or vaginal wall may be injured Superficial scalp abrasion Sloughing of the scalp CephalhematomaQ Subgaleal hemorrhage Intracranial hemorrhage rare Retinal hemorrhage Jaundice 