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Treatment method for cervical tear


The article is professionally consulted by Master, Doctor Nguyen Thi Hong On - Department of Obstetrics and Gynecology - Vinmec Phu Quoc International General Hospital.

Cervical tear is common in cases of difficult delivery, having to intervene with foocxep or early labor when the cervix is ​​not fully dilated, sometimes due to large abortion. In the case of a large tear of the cervix causing a lot of bleeding, the doctor will immediately restore it to stop the bleeding after the pregnancy and placenta. Small lacerations can stop bleeding on their own after delivery.

1. What is cervical tear? Causes and classification


Cervical tear is a tear in the lower or upper part of the vaginal attachment. Cervical tear is common in cases of difficult labor, having to intervene with foroxep or early labor when the cervix is ​​not fully dilated, sometimes due to large abortion.
In case the cervix is ​​torn and causes a lot of bleeding, doctors will immediately restore it to stop the bleeding after the pregnancy and placenta. Small lacerations can stop bleeding on their own after delivery.
Causes of cervical tear are scleroderma due to old tear, after cervical amputation, after cervical electrocautery, cervix is ​​edematous, inflammation due to long labor, premature straining to tear, delivery usually due to large fetus, suction...
Cervical tearing symptoms : Bleeding after delivery or before. Fresh bleeding, uterus still recovering well. Place the valve and use pliers to pull the cervix straight out, see if there is a tear from the sacrum to the outer edge, move the pliers around the cervix to see each short cervical segment from there to get an accurate diagnosis.
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Classification of cervical tear:
Cervical tear (CTC) is a common lesion with or without tearing of the vagina and perineum. Depending on the injury to classify the tear:
Tear of the cervix below the attachment of the vaginal wall, mild injury, bleeding more or less depending on the location of the tear Cervical tear above the attachment of the vaginal wall, mild injury, bleeding Less, more depending on the location of the tear Cervical tear often causes a lot of bleeding, but if not detected and treated promptly, it can cause shock and death.

2. Cervical tear affect next pregnancy?


Cervical tear at birth does not affect your ability to conceive, however cervical tear can be a big cause of miscarriage. Usually with small cervical tears at birth there is almost no effect, but if the tear is large (high tear) up to the waist of the uterus (internal hole) it is most likely the cause of miscarriage in the first time. posteriorly due to uterine isthmus.
Therefore, when there are signs and symptoms of cervical tear, you should go to a hospital with an obstetric unit to examine and listen to the advice of experts on this issue.

3. Treatment method for cervical tear

3.1. Preparation
Performer : One trained obstetrician in cervical laceration , 1 experienced midwife .
Means: Vaginal valve, Heart-shaped Pen, Antiseptic Pen, Straighten the blunt end (sharp), Pen clamp, Tweezers, No. 1 vicryl thread, 1 10ml syringe, Antiseptic solution.
Patient: The patient must be comprehensively evaluated for blood loss, pulse, blood pressure, general condition, degree of uterine contraction after delivery (if the contraction is poor, it is necessary to use uterine contraction drugs); maternal diseases, especially those related to hemostasis, such as thrombocytopenia, prolonged APTT, decreased fibrinogen...; The doctor needs to ask the patient and check the medical record to not miss the case of allergies to anesthetics, pain relievers, antibiotics.

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3.2. Steps to take


Step 1: Pain relief for the mother (if there is no epidural to relieve pain during and after childbirth). Step 2: Sew only the cervical tear and pay attention to clearly observe the two torn edges to sew and avoid stitching the lower lip and upper lip on both sides. Sew with self-dissolving thread. Step 3: Sew up the ectopic tear (with the same clothes if any) with a separate stitch.
3.3. Monitor patient's condition
Monitor general condition, pulse, blood pressure. Monitor bleeding: If bleeding, it must be carefully examined and sutured. Monitor blood loss, red blood cell tests, hemoglobin, when necessary blood transfusion. Administer antibiotics for 5 days after suturing. Cervical tear during childbirth not only causes pain for the mother but also affects her health later in life. In order to make the labor process easier, Vinmec International General Hospital now has methods of "Painless delivery" - helping mothers to have a gentle labor and healthy babies.

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