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    Subjects/OBG/Instrumental Delivery — Forceps, Vacuum
    Instrumental Delivery — Forceps, Vacuum
    hard
    baby OBG

    A 32-year-old multipara (G3P2) at 40+2 weeks is in the second stage of labor for 45 minutes. The fetal head is at +3 station in the left occiput anterior (LOA) position. Scalp is visible at the introitus without traction. Fetal heart rate is 135 bpm with moderate variability. The obstetrician applies a vacuum cup to the fetal head and performs traction. After 3 contractions, there is descent to +4 station. On the next contraction, the cup detaches from the fetal scalp. What is the most appropriate management?

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