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Objective <p>To assess the impact of intrapartum cervical tears on outcomes in subsequent pregnancies, with specific consideration of tear dimensions and anatomical location.</p> Design <p>A retrospective cohort study of all women with intrapartum cervical tears. Primary outcomes were recurrent cervical tears and subsequent preterm birth.</p> Results <p>On our cohort, 238 of 101,239 (0.23%) women who underwent vaginal delivery between August 2008 and May 2023, were diagnosed with intrapartum cervical tears. Among them, 116 (70%) were diagnosed with an anterior tear, 44 (26%) had a posterior tear, and 6 (4%) in both locations. Moreover, 56 (60%) had a tear of up to 2&#xa0;cm, and 42 (40%) had a tear larger than 2&#xa0;cm. Out of the women with cervical tears, 141 (59%) had a subsequent delivery. There was no significant difference in the rate of subsequent preterm birth (14% vs. 10%, OR 1.47 CI 95% 0.7–2.8, <i>p</i> = 0.26). Of the 141 who had a subsequent delivery, 107 (76%) delivered vaginally. A recurrent cervical tear had occurred only in 6 vaginal deliveries (5.4%), significantly higher compared to the overall incidence in our center (5.4% vs. 0.23%, OR 18.8 CI 95% 8.2–43.1, <i>p</i> &lt; 0.01). Four out of the 6 (67%) cases were in women with a cervical cerclage. The location or the size of the cervical tear did not affect the likelihood of a recurrent tear or subsequent preterm birth.</p> Conclusions <p>Intrapartum cervical tears are a significant risk factor for recurrent tears in subsequent pregnancies, yet with very low absolute incidence regardless of tear’s location and size. Most recurrences occurred in women with cervical cerclage.</p>

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Impact of intrapartum cervical tear on subsequent pregnancy outcomes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月24日

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  • Elchanan Dreyfuss,
  • Ofer Fischer,
  • Liron Seidman,
  • Or Bercovich,
  • Yarin Mash,
  • Eran Hadar,
  • Asaf Romano,
  • Ohad Houri

摘要

Objective

To assess the impact of intrapartum cervical tears on outcomes in subsequent pregnancies, with specific consideration of tear dimensions and anatomical location.

Design

A retrospective cohort study of all women with intrapartum cervical tears. Primary outcomes were recurrent cervical tears and subsequent preterm birth.

Results

On our cohort, 238 of 101,239 (0.23%) women who underwent vaginal delivery between August 2008 and May 2023, were diagnosed with intrapartum cervical tears. Among them, 116 (70%) were diagnosed with an anterior tear, 44 (26%) had a posterior tear, and 6 (4%) in both locations. Moreover, 56 (60%) had a tear of up to 2 cm, and 42 (40%) had a tear larger than 2 cm. Out of the women with cervical tears, 141 (59%) had a subsequent delivery. There was no significant difference in the rate of subsequent preterm birth (14% vs. 10%, OR 1.47 CI 95% 0.7–2.8, p = 0.26). Of the 141 who had a subsequent delivery, 107 (76%) delivered vaginally. A recurrent cervical tear had occurred only in 6 vaginal deliveries (5.4%), significantly higher compared to the overall incidence in our center (5.4% vs. 0.23%, OR 18.8 CI 95% 8.2–43.1, p < 0.01). Four out of the 6 (67%) cases were in women with a cervical cerclage. The location or the size of the cervical tear did not affect the likelihood of a recurrent tear or subsequent preterm birth.

Conclusions

Intrapartum cervical tears are a significant risk factor for recurrent tears in subsequent pregnancies, yet with very low absolute incidence regardless of tear’s location and size. Most recurrences occurred in women with cervical cerclage.