The association between location of postpartum cervical tear and maternal outcome – a retrospective Study

Abstract

To determine the associations between the location and characteristics of cervical tears with short-term maternal complications and outcome. This is a retrospective-cohort study. Included were all patients that delivered vaginally at our institute between the years 2009-2020, and diagnosed with a cervical tear. Maternal complications were compared between cases with posterior cervical tear and cases with anterior or lateral cervical tears. Exclusion criteria included patients who delivered by cesarean delivery and preterm labor (below 37.0 weeks of gestation). Overall, 96 patients were diagnosed with posterior cervical tear while 117 patients were diagnosed with anterior/ lateral tear. Maternal demographics and pregnancy characteristics were similar between the groups. There were also no differences in delivery outcomes between the groups. Patients with posterior cervical tears had higher rate of disseminated intravascular coagulation (DIC) (6.25% vs. 0.9%, p=0.04), and prolonged hospitalization (35.4% vs. 23.1%, p=0.05), as compared to patients with anterior/ lateral tears. There were no differences in other maternal complications. Cases of posterior cervical tear are at higher risk for maternal adverse outcome (DIC and prolonged hospitalization), as compared to cases of anterior/ lateral tears.