Spontaneous annular detachment of the cervix during labor

Abstract

Summary Annular detachment of the vaginal portion of the cervix during labor is a rare complication. The basic causes for the condition are an unyielding cervix, disproportion, and a faulty mechanism of labor. The unyielding cervix develops a circular line of cleavage and is torn away at its cervicovaginal junctiva. The fetal mortality has been extremely high (29 per cent). The high rate of stillbirths is due to the long labors, and the small pelves, not cervical detachment per se. In only one instance is spontaneous abortion mentioned as a sequel to cervical amputation. One would expect this to occur more often following amputation of the cervix. Our experience with pregnancy following cervical amputation is that spontaneous abortion occurs frequently. Four women here reported had successful subsequent pregnancies and vaginal deliveries. Gilles patient had five normal deliveries later. DeCosta's patient was later delivered by elective cesarean section. The indication for section was the former long difficult labor and the amputated cervix. An elective cesarean section is probably the best way to manage subsequent pregnancies. There will be exceptions to this rule.