Uterine Prolapse in Pregnancy: Two Cases Report and Literature Review

Abstract

Uterine prolapse complicating pregnancy is rare. Two cases are presented here: one patient had uterine prolapse at both her second and third pregnancy, and the other developed only once prolapse during pregnancy. This report will analyze etiology, clinical characteristics, complication, and treatment of uterine prolapse in pregnancy. Routine gynecologic examination should be carried out during pregnancy. If uterine prolapse occurred, conservative treatment could be used to prolong the gestational period as far as possible. Vaginal delivery is possible, but caesarean section seems a better alternative when prolapsed uterus cannot resolve during childbirth.

A rare case of utero-vaginal prolapse seen at third trimester: case report and review of literature

“…The most common are those whose symptoms are first recognised in pregnancy, they usually present in third trimester, the symptom may disappear following labour and delivery. 1,2,6 Our patient presented at 33 weeks' gestational age with stage three uterovaginal prolapse. In pregnancy, pelvic organ prolapse can lead to some complications such as spontaneous miscarriage, premature rupture of membrane, preterm labour, prematurity, recurrent urinary tract infection, acute urinary retention, cervical dystocia in labour, poor progress of labour, genital tract injuries, obstructed labour and postpartum haemorrhage.…”

“…It should be individualized, the considerations include, gestational age, severity of the symptoms, patients' wish, expertise available. [1][2][3]7,8 The options of management include conservative management as was done in our patient, this include admission for bed rest, good perineal hygiene, positional changes such as trendelenburg position. Other options include laparoscopic suspension or even use of pessary.…”

“…1 Uterovaginal prolapse occurs when there is weakness in any of the structures that contribute to the pelvic organ support such as ligaments, fascia, muscles and posterior angulation of the vagina. 1,2 Pelvic organ prolapse (POP) in pregnancy include those in which diagnosis was made prior to pregnancy which expectedly resolves spontaneously in second trimester when the uterus rises to become an abdominal organ, it gives minimal or no symptom as pregnancy advances while those that develop in during pregnancy most times occurs in the third trimester, the prevalence of which varies from 1 in 10,000 to 1 in 15,000.…”

“…Its associated with cervical edema, cervical dystocia in labour and prolonged obstructed labour because of inadequate cervical dilatation. 2,3…”

A Rare Case of Pregnancy Complicated by Uterine Prolapse and Cervical Fibroid

“…Conservative management in the form of bed rest, Trendelenburg position with manual reposition of the prolapsed mass is recommended. A pessary can be used to manage the prolapse throughout the pregnancy until the onset of labor [12][13]. Laparoscopic colposuspension surgery in early pregnancy has been reported, but it should be considered only when conservative management fails [14].…”