Abstract
Five cases of spontaneous necrosis and detachment of the cervix during labor are reported. Long labor, ruptured membranes, and a flat or contracted pelvis are predisposing factors. Pathogenesis is suggested as proceeding from pressure of the anterior lip of the cervix between the vertex and the symphysis, to congestion and edema and finally necrosis of the cervix. Then a cervicovaginal fistula forms with spontaneous detachment of the necrotic cervix.Prevention consists in the releasing of pressure on the trapped anterior lip of the cervix prior to the appearance of irreversible necrosis.
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