Intrapartum cervical lacerations and their impact on future pregnancy outcome

Batel Hamou, Eyal Sheiner, Tara Coreanu, Asnat Walfisch, Tali Silberstein

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: To investigate the significance of intrapartum cervical lacerations on subsequent pregnancies. Study design: A retrospective cohort analysis was conducted, comparing outcomes of subsequent singleton pregnancies, in women with and without a history of cervical lacerations in a previous delivery. Deliveries occurred between the years 1991–2014 at the Soroka University Medical Center. Multiple logistic regression models were constructed to control for clinically significant confounders. Results: During the study period 187,162 deliveries met the inclusion criteria. Of them, 429 (0.2%) occurred in women with a history of cervical lacerations in the previous pregnancy (study group). The study group exhibited significantly higher rates of recurrent cervical lacerations (21/429, 4.9% versus 275/187 162,0.1%, p value =.001), cerclage (13/429, 3% versus 260/187 162, 0.1% p value =.001), cervical incompetence (8/429, 1.9% versus 609/187 162, 0.3% p value =.001) cesarean delivery (CD) (97/429, 22.6% versus 26 280/187 162,14%, p value =.001), severe perineal tears (third or fourth degree; 2/429, 0.5%, versus 164/187 162, 0.1%, p value =.056) and blood transfusion (11/429, 2.6% versus 2448/187 162, 1.3%, p value =.022) as compared with the comparison group. Using a multivariable logistic regression model, history of cervical laceration in a previous pregnancy was found to be an independent risk factor for subsequent CD (OR 1.4, 95% CI 1.1–1.9), recurrent cervical laceration (OR 29.3, 95% CI 17.7–48.5), severe perineal lacerations (OR 11.7, 95% CI 5.1–27.2), and preterm delivery (OR 1.8, 95% CI 1.1–2.8) in the subsequent pregnancy. Conclusions: A history of intrapartum cervical laceration is an independent risk factor for recurrent cervical lacerations, CD, preterm delivery, and severe perineal lacerations in the subsequent pregnancy.

Original languageEnglish
Pages (from-to)883-887
Number of pages5
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume33
Issue number5
DOIs
StatePublished - 3 Mar 2020
Externally publishedYes

Keywords

  • Cervical incompetence
  • cervical tear
  • cesarean delivery
  • preterm labor
  • vaginal laceration

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