Partial annular cervical tear: A case report

An intrapartum cervical buttonhole tear: A case report and review of rare tear pathogenesis

“…The risk factors for cervical tears remain uncertain, with no consensus. The following have been proposed within the literature as possible risk factors: cervical cerclage, vacuum extraction delivery, nulliparity, early rupture of membranes, precipitous labour and the use of episiotomy [ 6 , 7 ]. Furthermore, prolonged labour is thought to increase the risk of all genital tract trauma, including cervical tears [ 8 ].…”

“…The mechanism behind intrapartum cervical tears remains to be elucidated. Several mechanisms have been postulated, including increased strength of contractions, bearing down on a cervix that has not reached full dilatation as well as iatrogenic response to multiple examinations of an oedematous cervix; these, however, remain lacking in conclusive evidence [ 6 ]. Previous studies have suggested that complex cervical tears may result from fibrotic changes to the cervix altering the distribution of pressure in an unbalanced fashion, applying more pressure to either the anterior or posterior lip of the cervix [ 5 ].…”

“…To date, reported intrapartum cervical tears include annular, bucket handle and avulsion tears, but not buttonhole tears of the cervix [ 5 ]. The literature has suggested that complex cervical tears lie on a mechanistic continuum stemming from buttonhole tears, extended to bucket handle and then to annular tears [ 6 ]. Nevertheless, there have been no previous reports of buttonhole cervical tears, the first step in this proposed mechanistic process.…”

Childbirth resulting in traumatic stretching and prolapsing of the anterior lip of the cervix outside the vagina: A case report

“…Additionally, there are reports of vaginal birth in women who had POP during labour [ [17] , [18] , [19] ]. However, some clinicians recommend elective caesarean delivery for the next pregnancy following a previous POP [ 20 ] or cervical trauma [ 21 ], despite the possible complications of caesarean delivery, and these make the preferred mode of delivery a contentious matter. Notably, there is a risk of recurrence of cervical trauma and prolapse in the next pregnancy.…”