of cervical tears
Review general care principles
and apply antiseptic solution to the vagina and cervix.
Provide emotional support and encouragement. Anaesthesia is not required for most cervical tears. For tears that are high and extensive, give pethidine and diazepam IV slowly(do not mix in the same syringe) or use
Ask an assistant to massage the uterus and provide fundal pressure.
Gently grasp the cervix with ring or sponge forceps. Apply the forceps on both sides of the tear and gently pull in various directions to see the entire cervix. There may be several
Close the cervical tears with continuous 0 chromic catgut (or
polyglycolic) suture starting at the apex (upper edge of tear), which is often the source of bleeding (Fig P-45).
long section of the rim of the cervix is tattered, under-run it with continuous 0 chromic catgut (or
apex is difficult to reach and ligate, it may be possible to grasp it with artery or ring forceps. Leave the forceps in place for 4 hours. Do not persist in attempts to ligate the
bleeding points as such attempts may increase the bleeding. Then:
- After 4 hours, open the forceps partially but do not remove;
- After another 4 hours, remove the forceps completely.
A laparotomy may be required to repair a cervical tear that has extended deep beyond the vaginal vault.
Repair of a cervical tear
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