Partial annular cervical tear: A case report

• Main Authors: Leah Mayne, Anusha Sudhahar, Mayooran Veerasingham
• Format: Article
• Language: English
• Published: Elsevier 2021-07-01
• Series: Case Reports in Women's Health
• Subjects: Annular tear; Cervical tear; Cervical laceration; Cervical avulsion; Case report
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214911221000382

Background: Intrapartum annular cervical tears are a rare pregnancy complication. The mechanisms underpinning these tears remain to be elucidated and currently the optimal management and future pregnancy implications remain unknown. Case Presentation: We present the case of a 35-year-old nulliparous woman who was diagnosed with a partial annular cervical tear following induction of labour. Her intrapartum course was also complicated by an intrapartum fever, prolonged labour induction and an antepartum haemorrhage. During the second stage of labour, a band of cervical tissue could be seen at the introitus and abutting the fetal head. Following normal vaginal delivery, a portion of cervical tissue was visualised, 2 cm thick by 5 cm long, avulsed at the lateral edge at 9 o'clock and extending in an annular anti-clockwise fashion towards 1 o'clock. She underwent surgical repair of the cervical tear and had an uneventful postnatal course. At 6 weeks post-partum her cervix appeared to be healing well with 2 cm length palpable on vaginal examination. Conclusion: To the best of our knowledge, this case is the first report of a partial annular cervical tear to present in this manner. While the optimal management and outcomes for tears of this nature remain unknown, we recommend prenatal ultrasound cervical length screening with consideration of a cervical cerclage and elective caesarean section, which could avoid pre-term birth or the recurrence of this type of tear in future pregnancies.