Nurse nicked cervix with fingernail??

Specialties Ob/Gyn

Published

Specializes in OB.

A friend of mine was describing her sister's birth and I was horrified by her description. The sister went in for induction (dont know why) and the nurse inserting her cervadil apparently cut her cervix with her fingernail. Her cervix swelled and she ended up needing a c-section. Later on she hemmorhaged (sp?) and spent the night in the ICU. I'm sure there is more to the story but I was wondering how this could happen through gloves? I would think her swollen cervix was more likely due to the baby's head being in a funny position or from the pitocin induced contractions or both. Anyone seen this happen before?

I think there's something else that went on. I think the probability of the nurse's gloved hand nicking the cervix is really quite small- and if it could happen, I guess it would have to be a substantial laceration in order to cause such swelling and hemorrhage.

I had a pt with a cervical lac go to the OR immediately after delivery with the worst hemorrhage I've seen to date, but it was attributed to the infant coming down so quickly that perhaps the baby's heel caused the lac.

In my (relatively short) OB nursing career, I've seen cervical swelling in pt's who ignored us and started pushing before they were fully and/or failure to descend, but not from a nurse's fingernail.

Can you tell us any more?

Specializes in L&D.

WHAT!! Highly unlikely. A small scratch on your cervix from what must have been a witches fingernail won't make you have to have a c/s. Your cervix received laceration foir different reasons and does just fine, birth, pap smear, kinky sex. I am finding that story hard to believe.

Specializes in High Risk In Patient OB/GYN.

I had a patient once who's cx was lacerated by our midwife. I don't know how--she does have long nails though (and a rough exam).

The poor woman started to hemorrhage. L&D nurses and docs told us she must have been pushing--weren't we telling her not to? Didn't we know she wasn't dilated? This is why only L&D nurses should be with laboring Pts.

:trout:

Let me tell you, I was with this woman ALL DAY (she was my only Pt, and a young, scared, non-english speaker), and this poor thing didn't give so much as a grunty push. Nada. There was no bleeding....midwife examines, 15 seconds later, small puddle in the bed...take her down....pretty large lac visualized. But nah, it was because she was pushing so hard on a closed cervix. :uhoh3:

So, yeah, I think it's possible.

kelly

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Long nails have no place in OB or newborn nursing, at any time.

However, I am finding this story hard to believe; it would have to have taken one HECK of a fingernail and a lot of work to create a nick that huge and troublesome.

And yes, I have seen one or two cervical lacs that were bad enough to warrant a trip to the OR for repair. One patient, nearly hemorrhaged to DEATH before it was stopped. They are that serious, but fortunately just as rare.

We recently had a pt with a varicosed cervical vein that bled impressively. She was and antepartum and it stopped in a couple of days.

Specializes in L/D, Peds.

I've never heard of that before. I am sure there is more to this story.

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