Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
Ann Palliat Med. 2021 Jun;10(6):7019-7027. doi: 10.21037/apm-20-1322. Epub 2020 Nov 17.
Uterine prolapse as a common form of pelvic organ prolapse (POP) is very rare during pregnancy. The literature was extremely limited concerning the management and causation of uterine prolapse during pregnancy women, especially in nulliparous women. We reported two cases of uterine prolapse in two primigravid female. Analysis and recommendations regarding the reasons and management of this condition was provided with past 20-year literature review. In our report, two patients noticed a lump protruding from vagina in the third and second trimester of pregnancy and were found uterine prolapse (28+3 weeks and 24 weeks of gestation respectively). One patient' prolapsed uterus cannot be returned spontaneously, vaginal packing with sterilized oil gauze and indwelling catheter were executed. She was hospitalized and with careful antenatal care. Corticosteroids were administered for fetal lung maturation. But the patient underwent emergency cesarean section because of obstetric factors two days later and two healthy twins were born. Another one treated with conservative antenatal management for a month, and with cesarean delivery at 33+6 weeks of pregnancy. After the delivery, patients were found no uterine prolapse at one-month post-partum examination. Successful pregnancy outcome of uterine prolapse depending on symptomatology, severity of the prolapse, obstructed status and the preference of patients; based on these facts require individualized management and treatment.
子宫脱垂作为一种常见的盆腔器官脱垂（POP）形式，在怀孕期间非常罕见。关于妊娠妇女子宫脱垂的处理和病因，文献资料极为有限，尤其是在初产妇中。我们报告了两例初产妇的子宫脱垂病例。通过对过去 20 年文献的回顾，对这种情况的原因和处理进行了分析和建议。在我们的报告中，两名患者在妊娠第三个和第二个三个月时注意到阴道内有肿块突出，并发现子宫脱垂（分别为 28+3 周和 24 周妊娠）。一名患者的脱垂子宫不能自行复位，进行了阴道填塞消毒油纱和留置导尿管。她住院并接受了仔细的产前护理。给予皮质类固醇促进胎儿肺成熟。但由于产科因素，两天后患者行急诊剖宫产，两名健康的双胞胎出生。另一名患者接受了一个月的保守性产前治疗，并在 33+6 周妊娠时行剖宫产。分娩后，患者在产后一个月检查时未发现子宫脱垂。子宫脱垂的成功妊娠结局取决于症状、脱垂的严重程度、梗阻状态和患者的偏好；根据这些事实，需要个体化的管理和治疗。
