Successful management of uterine prolapse during pregnancy with vaginal pessary: a case report

Abstract

The management and treatment of uterine prolapse in pregnancy should be individualized depending on the patient's preference. A vaginal pessary may be helpful to avoid complications of this condition and should be considered during patient counseling.

Uterine Prolapse during First Trimester Managed with Vaginal Pessary

“…The silicone-coated ring pessary is more convenient, since it can be removed easily by the patient (7). Common complications with pessaries are vaginal discharge, mucosal erosions of the vagina and odor (8). Our patient did not develop any of these complications.…”

Uterine prolapse in a primigravid woman

“…A PubMed keyword search for "uterine prolapse," "procidentia," or "pelvic organ prolapse" with "pregnancy" revealed very few reports of uterine prolapse newly diagnosed during pregnancy. In particular, less than 20 cases (only 18 cases) have been reported in the English-language literature since 2000 ( Table 1 ) [ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 ]. This is the third reported case of a uterine prolapse in a nulliparous female patient.…”

“…This is the third reported case of a uterine prolapse in a nulliparous female patient. The first was reported in Turkey and the second was in Japan [ 4 5 ]. Also, this is the first case in which the pregnancy ended in a vaginal delivery in a primigravid woman.…”

Uterine cervical prolapse following delivery

“…[2] The management strategies reported in the literature are conservative management, use of vaginal pessary, laparoscopic uterine suspension, and concomitant cesarean hysterectomy with abdominal sacrocolpopexy. [3] We present three cases of uterine prolapse which were managed by different strategies.…”

“…[6] and concomitant cesarean hysterectomy with abdominal sacrocolpopexy. [3] Perineal hygiene and bed rest in Trendelenburg position have been recommended and this is reported to be successful. Also, conservative management of uterine prolapse during pregnancy should be considered during the patient's counseling.…”