May 2008

Wilma Doedens Humanitarian Response Unit

UNFPA-Geneva

Vacuum Extraction

Kiwi Omnicup

Assisted vaginal delivery

• Up to 15% of all deliveries*

• Forceps or vacuum extraction (ventouse)

• Vacuum extraction is method of choice*

• RH in emergency settings (MISP)- BEmOC is part of MISP

- BEmOC includes assisted vaginal delivery

- Vacuum Extractor included in IA RH Kit 10

http://www.who.int/rhl/reviews/CD000224.pdf: Johanson RB, Menon V. Vacuum extraction versus forceps for assisted vaginal delivery. Cochrane Database of Systematic Reviews 1999,

In Kit 10: VE Malström

“traditional“ manual VE

New technology: Kiwi Omnicup

New technology: Kiwi Omnicup

VE with Kiwi Omnicup

Advantages Single operator Similar performance Compact, cheaper to ship Less risk of breakage?

Disadvantages Staff may need training Small parts can get lost Unknown durability

Including Kiwi in RH kit

Challenges

• Need WHO recommendation/support

• Sole manufacturer: Clinical Innovations

• Is the reuseable version useful in very low resource settings (crises)?

Next steps• Operational research with MSF: - Durability ease of use, cleaning and sterilization

- Questionnaires to 5 sites, results from 2 so far

- Analyse results and formulate recommendation

• Technical RH kit review meeting

Kiwi: experience so far

• Initial problems with product breakage and recommended cleaning process

• Adaptations made

• Interest is high

- site in Liberia was re-using disposable Kiwi!

• MSF convinced: included in catalogue