Bucket-handle cervical tear at term following oxytocin-induced vaginal delivery: a case report

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.