Cervical incisions in obstetrics

Abstract

A series of 84 patients is reviewed in whom cervical incisions were done because major maternal and/or fetal complications demanded termination of labor. Incisions of the cervix should play a definite but limited role in the practice of obstetrics. The incidence in this series was 0.66 per cent of the total deliveries during a seventeen-year period. If not technically so, cervical incisions to facilitate delivery must nonetheless be considered a major operation from the standpoint of the mother and fetus. Prolonged labor and occipitoposterior positions contributed to the majority of complications indicating cervical incisions. Severe cephalopelvic disproportion should serve as a contraindication to this procedure.Optimum conditions that should prevail before cervical incisions are done and the techniques used are described.Maternal morbidity occurred in 20.2 per cent and postpartum hemorrhage in 17.9 per cent. There were no maternal deaths.Careful selection of cases should yield a high fetal salvage (95.35 per cent in this series). It is believed that in this series many infants were saved by this procedure and the fetal benefits outweighed the hazards attendant to incising the cervix and operative delivery from below.