How Common Is Tearing During Childbirth?

Disease name. Refers to those who have a cervical fissure greater than 1 cm during delivery, with varying degrees of bleeding. Deeper cervical lacerations can extend upward to the vaginal fornix. When the first part of the vagina or the lower part of the uterus gives birth, there are slight tears on both sides of the cervical mouth, but the length is not more than 1 cm, and there is no obvious bleeding. It usually heals naturally quickly after giving birth, so it belongs to the normal range. Cervical laceration rate is an important indicator of obstetric quality. Severe cervical lacerations that are not detected and treated in time can cause maternal injuries to varying degrees and even endanger life.

Disease name. Refers to those who have a cervical fissure greater than 1 cm during delivery, with varying degrees of bleeding. Deeper cervical lacerations can extend upward to the vaginal fornix. When the first part of the vagina or the lower part of the uterus gives birth, there are slight tears on both sides of the cervical mouth, but the length is not more than 1 cm, and there is no obvious bleeding. It usually heals naturally quickly after giving birth, so it belongs to the normal range. Cervical laceration rate is an important indicator of obstetric quality. Severe cervical lacerations that are not detected and treated in time can cause maternal injuries to varying degrees and even endanger life.

Chinese name

Childbirth cervical laceration

Foreign name

Cervical laceration in childbirth

Birth cervical laceration I. Etiology:

(A) Spontaneous tearing:

If the cervix is not fully open, the maternal forcefully holds her breath; or if the uterine contraction is too strong and the cervix has not been fully expanded and has been broken by the pressure of the exposed part; or because the labor is too long, the cervix is pressed between the fetal head and the pelvis, As a result of edema and ischemia, if the ischemia is severe, some or all of the cervical necrosis may fall off; congenital developmental abnormalities such as a hard cervix and a long cervix may cause spontaneous incomplete rupture or ring-shaped shedding during delivery; The lower part of the uterus and the placenta previa covering the mouth of the cervix make the tissue fragile there. The lower part of the uterus and the cervix continue to expand after delivery, which is easy to be lacerated.

(2) Traumatic tear:

When the cervix is not fully opened, the cervix is artificially expanded, and the cervix is forced to expand violently, exceeding the pressure that the muscle fibers can withstand, which can cause the muscle fibers to break, that is, to perform vaginal midwifery or vaginal surgery, the operation method is incorrect, such as The forceps of the forceps are incorrectly placed outside the cervix, or the method of rotating the fetal head with the forceps is improper, or the cervix was strongly supported during the first stage of labor, in an attempt to stimulate the contractions and promote the rapid expansion of the cervix, making the cervix unable to fully expand And tearing.

(Three) autopathy:

Cervical tissue lesions, such as cervical edema, scarring, tenacity, and inflammatory erosion, can reduce the elasticity of the cervical tissue, become brittle and easily broken, causing cervical laceration during delivery.

(4) Other factors:

In addition, intravenous drips of higher concentrations of oxytocin induce or induce labor. The use of oxytocin can cause uterine contractions to be too frequent and too strong, the cervix has no time to expand, and the fetus breaks through the cervix and quickly declines. It can also cause cervical laceration in some pregnant women with congenital cervical dysplasia.

Partial cervical laceration 2. Clinical diagnosis:

(1) Medical history:

Active vaginal bleeding occurs after childbirth and drainage, which is persistent, bright red, and has no effect on improving contractions.

(Two) physical examination:

Open the vagina to expose the cervix, check the cervix sequentially for a week, and find the cervical laceration and the size of the rift.

Partial cervical laceration III. Treatment and prevention:

Repair of the cervix should be performed immediately after suture, and antibiotics should be used to prevent infection. The prevention of this disease should be done as follows: Do a good job of propaganda to pregnant women, do not hold your breath down until the cervix is fully opened. Strictly grasp the indications and contraindications for vaginal midwifery. It is not advisable to perform vaginal midwifery before the cervical opening is fully opened. Do any intravaginal or intrauterine operation gently and correctly to avoid violence.