title: Cervical insufficiency following cesarean delivery after prolonged second stage of labor: experiences of two cases.
abstract: Cervical insufficiency is a known risk factor for preterm birth and miscarriage. The etiology of cervical insufficiency has not been fully recognized and the association between it and prior cesarean delivery is unknown. We experienced two similar characteristic cases of cervical insufficiency following term cesarean delivery. Interestingly, both cesarean sections were uneventfully performed after the prolonged second stage of labor. Our experience and recent literature strongly support the idea that an unintentional incision into the uterine cervix during a previous cesarean section may cause cervical insufficiency in subsequent pregnancies. It is important for obstetricians to take into account the possible occurrence of cervical insufficiency depending on the circumstances of previous deliveries. Our report highlights the need to alert obstetricians to take more care with their cesarean section technique.
authors.affiliation: Division of Obstetrics and Gynecology, Department of Specific Organ Regulation, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan. skoyama@gyne.med.osaka-u.ac.jp
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Koyama
authors.forename: Takuji
authors.initials: T
authors.lastname: Tomimatsu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kanagawa
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Sawada
authors.forename: Tateki
authors.initials: T
authors.lastname: Tsutsui
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000328:Adult; D023802:Cerclage, Cervical; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D007748:Labor Stage, Second; D011247:Pregnancy; D016896:Treatment Outcome; D002581:Uterine Cervical Incompetence / Q000209:etiology* / Q000601:surgery