Outcomes of Obstetric Cervical Trauma

Abstract

Trauma to the cervix during childbirth is still a common problem in obstetrics. The issue of etiology and risk factors is still extremely controversial. The high risk of long-term consequences of cervical injuries creates the need for timely prediction and effective prevention of this complication of childbirth, which seems to be the main reserve for reducing cervical insufficiency and associated pathological conditions in the future. Aim To establish the main predictors of obstetric cervical injury. Materials and methods. A prospective cohort study of women who were observed as outpatients and then gave birth at clinical sites was conducted. Department of Obstetrics and Gynecology. between September 2020 and January 2022. Monitoring of patients began from the day of their first appearance at the antenatal clinic and continued throughout pregnancy. Particular attention in the study program was paid to a comprehensive perineological examination. Results. In group 1, there were many grade I and II tears (n=37, 33% and n=24, 29%) and there were no grade III tears. In the 2nd group, there were third-degree cervical ruptures, the frequency was (n=5), but still their number was lower than I and II-degree ruptures (n=10 and n=15). In the 3rd group, the analysis showed a small frequency of grade I and II cervical ruptures (n=8 and n=15) and a comparable number of grade III ruptures to the 2nd group (n=8). Episiotomy in all groups was performed in the range from 7 to 9%, strictly according to obstetric indications. Conclusion. According to the data obtained, the most significant clinical and anamnestic predictors of obstetric perineal trauma were a history of abortion, chronic diseases of the ENT organs and urinary system, disturbance of the vaginal microbiocenosis (nonspecific vaginitis, bacterial vaginosis), changes in the pH of the vaginal environment, the presence of a scar on the cervix.