Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
Arch Gynecol Obstet. 2022 Dec;306(6):1949-1952. doi: 10.1007/s00404-022-06483-7. Epub 2022 Mar 11.
Uterine prolapse in pregnancy is an uncommon occurrence that can lead to a wide spectrum of complications. Postpartum Group A Streptococcus (GAS) endometritis is a rare but life-threatening condition. Our aim was to review the literature regarding management of prolapse in pregnancy and maternal infection as a rare complication.
We present a case of uterine prolapse with cervical elongation presenting in the third trimester. The patient's prolapse was refractory to pessary management. She was induced at 36 weeks due to an abnormal fetal heart tracing and had an uncomplicated vaginal delivery. Her postpartum course was complicated by GAS endometritis and septic shock. She recovered after antibiotic therapy and her prolapse did not recur postpartum.
Prolapse during pregnancy carries a risk of several complications but does not preclude a vaginal delivery. Management must be patient-centered and individualized. GAS sepsis is a potential, rare, and life-threatening postpartum complication requiring swift identification and treatment.
妊娠子宫脱垂并不常见，但可导致广泛的并发症。产后 A 组链球菌（GAS）子宫内膜炎是一种罕见但危及生命的疾病。我们的目的是回顾妊娠子宫脱垂和产妇感染作为罕见并发症的文献。
我们报告了一例妊娠晚期宫颈延长的子宫脱垂病例。患者的脱垂对子宫托治疗无反应。由于胎儿胎心监护异常，她在 36 周时被引产，并顺利经阴道分娩。她的产后病程并发 GAS 子宫内膜炎和感染性休克。她在接受抗生素治疗后康复，脱垂未在产后复发。
妊娠期间的脱垂有多种并发症的风险，但并不排除阴道分娩。管理必须以患者为中心并个体化。GAS 败血症是一种潜在的、罕见的、危及生命的产后并发症，需要快速识别和治疗。
