足月产妇因缩宫素诱导的阴道分娩后发生桶柄状宫颈撕裂：病例报告。
Bucket-handle cervical tear at term following oxytocin-induced vaginal delivery: a case report.
机构信息
Department of Obstetrics and Gynecology, Saint Paul's Hospital millennium Medical College, Addis Ababa, Ethiopia.
出版信息
J Med Case Rep. 2022 Feb 15;16(1):79. doi: 10.1186/s13256-022-03269-y.
BACKGROUND
A bucket-handle cervical tear, a laceration of the anterior or the posterior lip of the cervix so that it hangs like the handle of a bucket, is the rarest type of cervical laceration. Our case represents such a serious cervical laceration. A 28 year-old para 2 (both vaginal deliveries) Ethiopian mother presented at term with prolonged rupture of membrane. After 8 hours of oxytocin induction, a bucket-handle cervical detachment was detected at the time of her vaginal delivery, up on digital pelvic examination. Delivery of the baby was noted to be through the cervical tear, not the cervical opening. Cervix was amputated at the level of the cervical tear, 4 days after a failed initial repair surgery.
CONCLUSION
When bucket-handle cervical tear is encountered, a thorough clinical evaluation of the viability of the cervical tissue and feasibility of a repair procedure should be made during the first surgery. If the cervical detachment is near total, as in our case, we recommend amputation of the hanging cervical tissue from the outset.
背景
桶柄状宫颈撕裂，是指宫颈前唇或后唇的撕裂，使其像桶柄一样悬挂，是最罕见的宫颈撕裂类型。我们的病例代表了如此严重的宫颈撕裂。一位 28 岁、经产 2 次（均为阴道分娩）的埃塞俄比亚母亲足月时胎膜破裂时间延长。催产素诱导 8 小时后，在阴道分娩时通过数字骨盆检查发现桶柄状宫颈分离。注意到婴儿是通过宫颈撕裂处分娩，而不是宫颈开口。在初次修复手术失败后 4 天，在宫颈撕裂处水平切断了宫颈。
结论
当遇到桶柄状宫颈撕裂时，在第一次手术中应对宫颈组织的活力和修复手术的可行性进行彻底的临床评估。如果宫颈分离接近完全，就像我们的病例一样，我们建议从一开始就切除悬挂的宫颈组织。
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