What is provoked and how is cervical rupture treated?

2023 Author: Alfred Shackley | [email protected]. Last modified: 2023-05-21 13:14

Rupture of the cervix is a deep or superficial violation of the integrity of tissues that occurs due to the passage of the fetus through the birth canal. The incidence of tears is significantly higher in women who give birth for the first time.

We will consider the main causes of the pathological process, the possible consequences and methods of treatment.

Why do breaks occur?

Ruptures of the uterus occur due to a strong thinning of the walls of the uterine pharynx. This, in turn, significantly increases the likelihood of tissue damage during childbirth.

Specialists identify several causes of injury:

• Low tissue elasticity. Women after 30 years of age are much more likely to suffer from the appearance of microcracks and tears than younger women;
• Anomalies. When the fetus passes through the birth canal, the full disclosure of the uterus does not always occur, which is also fraught with damage;
• Inflammation. Inflammatory processes, as well as scars, make tissues less elastic;
• Fast delivery. The rapid passage of the fetus through the birth canal leads to damage to the cervical canal, which connects the vagina to the uterus;
• Large head sizes. Too large a fetal head contributes to stretching and, as a result, a violation of the integrity of the smooth muscle organ;
• Surgery. When artificially removing a newborn, metal forceps are used, which injure the already thinned walls of the birth canal;
• Improper obstetrics. The incompetence of the doctor also leads to the formation of cracks in the smooth muscle organ.

How do you know if a break has occurred?

Unfortunately, identifying the problem is not always easy. In some cases, micro-ruptures do not make themselves felt in any way. However, organ damage can lead to inflammation.

How to understand that a rupture of the cervix during childbirth did occur?

• Spotting of bright red color appears;
• The woman is dizzy;
• The skin becomes paler;
• Cold sweat comes out.

It should also be noted that cracks up to 0.5 cm in size do not cause any discomfort to the woman in labor. But after childbirth, the specialist must make an appropriate examination to determine the presence of micro-tears on the inner walls of the birth canal.

The main forms of damage

A pathological change in the state of tissues can occur both spontaneously and violently.

What is the reason for the spontaneous formation of ruptures?

• Rigidity of tissues. Often, during pregnancy, the membranes of a smooth muscle organ lose their elasticity and become looser and more prone to damage;
• By squeezing the neck of the organ. It is often found in women in labor with a narrow pelvis. Because of this, there is an insufficient blood supply to the tissues and their thinning;
• Fetal activity. Inside the womb, the fetus can rotate, which leads to excessive stretching of the organs and the loss of elasticity.

Violently caused pathologies occur during delivery operations:

• using forceps;
• using a vacuum extractor;
• incision of the perineum.

Breakage rates

Depending on the depth and length of the cracks, there are 3 degrees of damage to the cervix:

• Ruptures of the uterine cervix of the 1st degree can be on one or two sides. The extent of damage varies from 3 to 20 mm;
• Ruptures of the uterine neck of the 2nd degree do not reach the fornix, but reach 20 mm or more;
• Deeper and longer tears that reach the vaginal vault.

The most dangerous is the birth pathology of the third degree. In this case, the violation of the integrity of the tissues can reach not only the fornix, but also the uterine pharynx. This is fraught with profuse hemorrhages in the region of the parametric (peri-uterine) tissue.

No less dangerous are the old healed ruptures of the cervix, which are formed after improper rehabilitation. "Old wounds" often manifest themselves as erosion and may bleed after intercourse or heavy physical exertion. Ignoring the problem leads to the appearance of ectropion, which significantly increases the risk of developing cancer.

Possible complications

Can pathology have consequences? Unfortunately, injuries to the birth canal often cause complications, especially without an adequate course of rehabilitation.

What are the consequences of women in labor?

• Severe hemorrhages;
• Hemorrhagic shock;
• Cicatricial deformities;
• Isthmic-cervical insufficiency;
• Endometritis and infertility;
• Inversion of the neck;
• Miscarriage during subsequent pregnancy;
• Postpartum ulcers.

It should be noted that cicatricial formations significantly reduce the elasticity of the smooth muscle organ. This increases the likelihood of abnormalities in the next birth. Obviously, the consequences of a rupture of the cervix during difficult childbirth are quite serious, therefore, if a problem is found, it is necessary to undergo treatment.

How to diagnose pathology?

Before starting treatment, it is necessary to undergo an examination that will determine the depth and extent of the tears.

How does this happen?

1. Analysis of the patient's complaints. The specialist clarifies the presence of complaints, the nature of pain and the duration of bleeding, if any;
2. Inspection. The doctor feels the abdomen and uterus, which allows you to determine the presence of pathology;
3. Analysis of the obstetric history. The specialist evaluates the degree of difficulty of childbirth, the presence of prenatal health problems, the physiological characteristics of the patient, which allows you to choose an adequate course of treatment;
4. External examination. By palpation, the doctor determines the size and presence of deformities in the uterus, as well as the degree of muscle tension. This allows you to establish the fact of internal bleeding;
5. Inspection with wide mirrors. To diagnose minor tears, the doctor examines the vagina and uterus with a special instrument.

And only after clarifying the general clinical picture, treatment can be prescribed. In this case, the negative consequences after undergoing rehabilitation will be minimal.

Treatment

For the treatment of cervical ruptures in difficult labor, doctors resort to two main methods:

1. Sewing up. Bleeding cracks are sutured, which significantly speeds up the process of tissue regeneration;
2. Gluttony. In complex pathologies with the formation of deep and extended ruptures, an abdominal operation is performed with the opening of the peritoneum. Thus, it is possible to eliminate bleeding in the parametria and exclude the possibility of hematoma formation.

After completing all the necessary manipulations, the doctor prescribes sparing drugs that increase the body's immune defenses.

Thanks to this, the risk of purulent inflammation and erosion of damaged organs is significantly reduced.

Generic pathologies associated with a tear of the cervix and vagina are fraught with serious complications. To eliminate the problem and possible consequences, it is necessary to undergo treatment and only after preliminary diagnosis.