Instrumental Delivery — Forceps, Vacuum

A 32-year-old multiparous woman at term is in the second stage of labour. After 45 minutes of pushing, the fetal head is at +1 station, in the right occiput transverse (ROT) position. Cardiotocography shows variable decelerations with good baseline variability. The obstetrician attempts vacuum extraction but fails to achieve delivery after 3 contractions with no descent. What is the most appropriate next step?

What is the maximum recommended traction force (in kg) that should be applied during a vacuum extraction to minimize the risk of scalp trauma and cephalohematoma?

Regarding the prerequisites and conditions for safe forceps delivery, all of the following are TRUE except:

A 28-year-old G2P1 at 39 weeks is in the second stage of labor. The fetal head is at station +1, and the mother has been pushing for 90 minutes with minimal progress. The obstetrician is considering operative vaginal delivery. Which finding best distinguishes a candidate suitable for vacuum extraction over forceps delivery?

A 28-year-old primigravida at term is in active labor with a vertex presentation. After 2 hours of pushing in the second stage, the fetal head is at +2 station with caput succedaneum and molding noted. The obstetrician plans instrumental delivery. Which investigation is most appropriate to assess fetal well-being and confirm the indication for operative vaginal delivery?