Impact of intrapartum cervical tear on subsequent pregnancy outcomes

To assess the impact of intrapartum cervical tears on outcomes in subsequent pregnancies, with specific consideration of tear dimensions and anatomical location. A retrospective cohort study of all women with intrapartum cervical tears. Primary outcomes were recurrent cervical tears and subsequent preterm birth. On our cohort, 238 of 101,239 (0.23%) women who underwent vaginal delivery between August 2008 and May 2023, were diagnosed with intrapartum cervical tears. Among them, 116 (70%) were diagnosed with an anterior tear, 44 (26%) had a posterior tear, and 6 (4%) in both locations. Moreover, 56 (60%) had a tear of up to 2 cm, and 42 (40%) had a tear larger than 2 cm. Out of the women with cervical tears, 141 (59%) had a subsequent delivery. There was no significant difference in the rate of subsequent preterm birth (14% vs. 10%, OR 1.47 CI 95% 0.7–2.8, p = 0.26). Of the 141 who had a subsequent delivery, 107 (76%) delivered vaginally. A recurrent cervical tear had occurred only in 6 vaginal deliveries (5.4%), significantly higher compared to the overall incidence in our center (5.4% vs. 0.23%, OR 18.8 CI 95% 8.2–43.1, p < 0.01). Four out of the 6 (67%) cases were in women with a cervical cerclage. The location or the size of the cervical tear did not affect the likelihood of a recurrent tear or subsequent preterm birth. Intrapartum cervical tears are a significant risk factor for recurrent tears in subsequent pregnancies, yet with very low absolute incidence regardless of tear’s location and size. Most recurrences occurred in women with cervical cerclage.