Risk of Intrapartum Cervical Lacerations in Vaginal Singleton Deliveries in Women With Cerclage.

BACKGROUND: We examined the obstetric outcomes of singleton vaginal deliveries in women with cerclage at our institute to confirm the risk of intrapartum cervical lacerations in vaginal deliveries of women with cerclage.

METHODS: Data on all Japanese singleton vaginal deliveries at ≥ 34 weeks' gestation managed at the Japanese Red Cross Katsushika Maternity Hospital between 2008 and 2014 were collected.

RESULTS: During the study period, cervical cerclage was performed in 95 of 9,490 (1.0%) women with singleton pregnancy at 12 - 22 weeks of singleton pregnancy who delivered at ≥ 34 weeks' gestation. The incidence of intrapartum cervical lacerations and postpartum hemorrhage ≥ 1,000 mL in the women with cerclage were higher significantly than that in the women without cerclage (cervical lacerations: crude odds ratio (OR): 26.9, 95% confidence interval (CI): 14 - 51, P < 0.01; postpartum hemorrhage: crude OR: 2.86, 95% CI: 1.6 - 4.9, P < 0.01). Using a multivariate analysis, cerclage was independently associated with the increased incidence of intrapartum cervical lacerations (P < 0.01).

CONCLUSIONS: Cervical cerclage is an independent risk factor of intrapartum cervical lacerations in vaginal deliveries.