Zafran Noah, Gerszman Eden, Garmi Gali, Zuarez-Easton Sivan, Salim Raed
Department of Obstetrics and Gynecology, Emek Medical Center, 18101, Afula, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Arch Gynecol Obstet. 2017 Aug;296(2):199-204. doi: 10.1007/s00404-017-4410-0. Epub 2017 Jun 6.
To examine the occurrence of subsequent preterm birth (PTB) among women who experienced a cervical tear during prior delivery.
A retrospective study conducted at a single teaching hospital on data from January 1994 to March 2014. The study group included all women who had a cervical tear detected at uterine and cervical examination, performed due to early postpartum hemorrhage. The control group consisted of women who delivered vaginally, experienced an early postpartum hemorrhage, and had an intact cervix at uterine and cervical examination. The control group was matched for maternal age and ethnicity at a ratio of 1:2. Women who had a cervical tear but then did not have a subsequent delivery, or had multiple fetal gestations or cervical cerclage at subsequent pregnancies were excluded. Primary outcome was spontaneous PTB rate (<37 weeks) in the subsequent pregnancy. Secondary outcomes included any PTBs in other subsequent pregnancies.
Overall, 389 women were included. Of all cases of cervical tear, 129 were identified eligible and included in the final analysis. The control group included 260 women with an intact cervix. No significant differences were found between the study and control groups in the incidence of spontaneous PTB in the immediate subsequent pregnancy [1.6% (2/129) vs. 3.8% (10/260), respectively, p = 0.35]. The incidence of any spontaneous PTBs in all subsequent pregnancies did not differ also [4.7% (6/129) vs. 7.3% (19/260), respectively, p = 0.31].
Cervical tear detected after delivery does not increase the risk of spontaneous PTB in subsequent pregnancies.
研究既往分娩时发生宫颈撕裂的女性中后续早产（PTB）的发生情况。
在一家教学医院进行一项回顾性研究，研究数据来自1994年1月至2014年3月。研究组包括所有因产后早期出血进行子宫和宫颈检查时发现宫颈撕裂的女性。对照组由经阴道分娩、经历产后早期出血且子宫和宫颈检查时宫颈完整的女性组成。对照组按1:2的比例与研究组进行产妇年龄和种族匹配。排除分娩后有宫颈撕裂但之后未再次分娩、或后续妊娠为多胎妊娠或进行宫颈环扎的女性。主要结局是后续妊娠中的自然早产率（<37周）。次要结局包括其他后续妊娠中的任何早产情况。
总体纳入389名女性。在所有宫颈撕裂病例中，129例被确定符合条件并纳入最终分析。对照组包括260名宫颈完整的女性。研究组和对照组在紧接着的后续妊娠中自然早产发生率方面未发现显著差异[分别为1.6%（2/129）和3.8%（10/260），p = 0.35]。所有后续妊娠中任何自然早产的发生率也无差异[分别为4.7%（6/129）和7.3%（19/260），p = 0.31]。
分娩后发现的宫颈撕裂不会增加后续妊娠中自然早产的风险。
