Vaginal Delivery through Posterior Cervical Tear without Dilatation of Cervical Os.

ABSTRACT

A 23-year-old primigravida with no previous history of abortions or miscarriages with spontaneous conception and singleton pregnancy was admitted to the labour ward at 40 weeks 5 days of gestation for induction of labour. She had antenatal workup and immunization as per standard antenatal care (ANC) protocol with regular antenatal visits. She had uneventful antenatal period without any high-risk factors (no hypertension, gestational diabetes or anaemia). There was no history of any medical illness and abdomino-pelvic surgical interventions.On examination, her vital parameters were normal. Uterus full term gestation with fetus in longitudinal lie and cephalic position. Liquor appeared adequate and fetal heart sounds were heard at normal rate in the left lower quadrant. Ultrasonography done prior to admission showed normal findings with estimated baby weight of 2.8 Kg and normal Doppler flows and adequate liquor.Speculum and digital examination was done on admission which revealed the following- No cervical or vaginal injuries or lesions. A long tubular cervix (approx. 2 cm-2.5 cm), midpositioned admitting just tip of a finger. No bleeding or leaking with a BISHOPS score of 4.(1)