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.

Figures

Figure 1

Ring pessary.

Figure 2

Pelvic floor four-dimensional ultrasound of Case 2. Pelvic floor four-dimensional ultrasound indicated that residual urine was 0 ml, thickness of detrusor was normal, internal orifice of urethra was closed, posterior angle of bladder was intact, and there was no dark area of liquid and scattered point of calcification around urethra in quiescent condition. CDFI revealed that sparse color flow signals were seen around the urethra, the bladder neck was 19 mm above the pubic symphysis, the uterus was 17 mm above the pubic symphysis, and ampulla portion of rectum was located at the pubic symphysis. Bladder neck displacement was 15 mm, bladder neck was located 9 mm below the pubic symphysis, posterior angle of bladder was intact, the uterus was 35 mm below the pubic symphysis, ampulla portion of rectum was located at the pubic symphysis, rectocele was not seen, and anal sphincter was complete in Valsalva.