Vacuum extraction, a procedure used for forced delivery, is effective in assisting vaginal delivery but can cause maternal and fetal complications. Therefore, before the procedure is performed, it should be confirmed that indications and conditions are appropriate for vacuum extraction in accordance with the guidelines for obstetrical practice in Japan. If the procedure cannot be carried out smoothly, alternative delivery procedures should be considered. In addition, if forced delivery by vacuum extraction cannot be completed, forceps delivery or cesarean section must be performed as soon as possible. In particular, when uterine fundal pressure is used in combination with vacuum extraction, findings during the delivery must be documented in detail in the medical record. Finally, neonates born by vacuum extraction should be carefully observed for a certain period of time.

Aim: Growing evidence exists on the association between hypertensive disorders of pregnancy (HDP) and long-term cardiovascular and metabolic disease risks. Here we evaluated obstetric care providers’ knowledge of future HDP-related risks and their engagement in counseling women with HDP in Japan.

Methods: A questionnaire-based survey regarding knowledge of HDP and counseling practices of obstetric care providers in Aichi Prefecture was conducted via a web-based platform from March to June 2024.

Results: A total of 169, 402, and 135 valid responses were obtained from obstetrician-gynecologists, midwives, and nurses, respectively. While more than 80% of the obstetrician-gynecologists were aware of HDP-related risks, only 29.6% regularly provided counseling, while 24.2% rarely or never engaged in such practices. The primary reason for not providing counseling was a lack of knowledge about counseling methods and necessary content, followed by unavailability of appointment slots and time constraints. Among midwives and nurses, approximately 40% rarely or never provided counseling, while many lacked knowledge of the preventive use of low-dose aspirin (67.2%).

Conclusions: This survey demonstrated that, despite a high level of knowledge among healthcare providers, there is a substantial gap between knowledge and the implementation of counseling practices. These findings highlight the need for targeted education and training programs for obstetric care providers.

Aim: To evaluate the utility of a three-dimensional (3D) labor simulation technique based on low-dose computed tomography.

Methods: We obtained computed tomography data for an expectant mother who required pelvimetry to diagnose cephalopelvic disproportion at 36 weeks’ gestation. Using low-dose computed tomography data, 3D models of the maternal pelvis and the fetal head were created, based on which simulations to predict labor progression were performed. The patient provided informed consent for the use of her data for research purposes.

Results: Our low-dose computed tomography protocol has been demonstrated to result in lower radiation exposure (0.17 mGy) than conventional X-ray pelvimetry (0.50–1.18 mGy). Computed tomography images clearly visualized the pelvic and fetal head dimensions. The 3D cephalopelvic model effectively demonstrated the spatial relationship between the fetal head and the maternal pelvis, allowing for a comprehensive assessment that could simulate labor progression.

Conclusions: This novel 3D simulation system based on low-dose computed tomography not only offers a minimally invasive and informative means to predict labor progression but also provides a visual and tactile method for assessing fetal progression through the birth canal, potentially improving the accuracy of prediction of cephalopelvic disproportion. Further large-scale studies will be necessary to validate the clinical efficacy and safety of this 3D simulation system.