What Is Cervical Trauma?

Cervical lacerations generally refer to lacerations of more than 1 cm at the cervix, which most often occur after childbirth or after the operation of the uterine cavity. If the laceration is deep, it was not sutured at that time, or when the alignment is poor and the healing is not good, it is recovered in the cervix. Later, you can see the cervical opening dehiscence, showing a large transverse fissure or split into several flaps, clinically known as the old cervical laceration.

Cervical lacerations generally refer to lacerations of more than 1 cm at the cervix, which most often occur after childbirth or after the operation of the uterine cavity. If the laceration is deep, it was not sutured at that time, or when the alignment is poor and the healing is not good, it is recovered in the cervix. Later, you can see the cervical opening dehiscence, showing a large transverse fissure or split into several flaps, clinically known as the old cervical laceration.

Chinese name

Old cervical laceration

Foreign name

Old cervical laceration

Old cervical laceration 1. Cause:

Many researchers believe that the occurrence of this disease is mainly caused by the excessive uterine contraction and the dysfunction of the cervix, which causes the contents of the uterine cavity to be squeezed between the inner and outer cervix of the cervix under uterine contraction. rupture. The cuspids during pregnancy are mostly forward flexed, which is the cause of posterior labial laceration. Some people think that the application of misoprostol and oxytocin in the process of induction of labor may increase the disease. The proportion of the fetal head in the second trimester increases, and the cervix should be fully expanded when the baby is delivered. If the cervix is not sufficiently dilated, spontaneous cervical damage is likely to occur. Many scholars believe that poor cervical dilatation is associated with genital development, immature cervical stenosis, narrow external mouth, and poor cervical fibrous elasticity.

Cervical lacerations are often accompanied by cervical canal mucosa eversion, shortening of the cervix, cervical canal mucositis, cervical dysfunction of the cervix, clinical manifestations of increased leucorrhea, contact bleeding, vaginal bleeding after menstruation, habitual abortion, IUD fallout, and Pelvic pain and so on.

Old cervical laceration 2. Differential diagnosis:

The clinical classification and diagnosis criteria of old cervical laceration: Type laceration: It is a full-thickness laceration of the cervix, which leads to eversion of the cervical canal mucosa and looks like cervical hypertrophy. Palpation of the cervix shortened, palpable wounds could be palpated, and careful inspection of the entire layer of the cervix showed no significant thickening. The laceration is usually at 3 and 9 o'clock in the cervix. Clinically it is often misdiagnosed as "cervical erosion" or "cervical hypertrophy" and treated. Type lacerations: lacerations of the cervical canal mucosa and cervical inner tissues, but no lacerations of the vaginal mucosa and cervical outer tissues. Due to the inner layer laceration, the tissue retracts, so when the uterus is in the normal position, the retracted and thickened tissue protrudes toward the cervix, like a cervical fibroid. Palpation of the cervix is loose enough to accommodate the fingers, and the cervix is not shortened. Type III laceration: The laceration is irregular or there are more than three lacerations, and sometimes the cervix is "rabbit-like".

Have a history of induction of labor; gynecological examination of the cervical external opening is round, the posterior lip sees an oval external wound, bright red, and the edges are scarlike and hard. Probe with a probe to enter the uterine cavity from the cervical opening and fissure. diagnosis.

Old cervical lacerations 3. Inspection:

Leucorrhea examination, BV, blood routine, ECG, HPV, TCT, electronic colposcope, and cervical biopsy were performed to exclude cervical malignant lesions before surgery.

Old cervical lacerations IV. Treatment principles:

Cervical laceration repair is performed to restore normal cervical morphology and function. All patients underwent a combined spinal anesthesia.

1. Exposed lacerated cervix:

Put the vaginal hook, pull the front and back neck lips with two rattooth pliers, and pull down to make the laceration exposed to the maximum, and see the top of the laceration.

2. Judging part of the cut:

A No. 5 expansion rod or a 15cm curved hemostatic forceps is built into the cervical canal. The location of the cervical fissure wound is judged. The edge of the laceration is scratched with the blade tip to mark the tissue to be removed. Observe whether there is enough mucosa to form a new cervical canal. .

3. Make a fresh wound:

Remove the old wounds and scars on the lip between the lines. The incision extends to the cervical and vaginal mucosa and the cervical canal mucosa. Pay special attention to the removal of old wounds at the top of the laceration, resulting in fresh and healthy wounds. Trim the edges of fresh wounds. Type II lacerations should involve cervical outer tissue and vaginal mucosa Cut them together.

4. Suture the wound:

Intermittent suture with 0 absorbable thread. The suture starts from the top and gradually outwards. The suture runs through the entire layer of the cervical wall. After the suture is completed, the lumen of the cervical canal should be easily placed into a cervical dilatation rod No. 4.