Taha Walaa, Zabad Kareem, Nahhat Fouad, Kurdi Bashar
University Hospital of Obstetrics and Gynecology.
Faculty of Medicine, Damascus University, Damascus, Syria.
Ann Med Surg (Lond). 2023 Jul 8;85(8):4153-4156. doi: 10.1097/MS9.0000000000001044. eCollection 2023 Aug.
Uterine prolapse (UP) is rare during pregnancy. It sometimes leads to serious complications such as abortion, preterm labor, and maternal death. The main risk factor for UP is previous vaginal childbirth and is usually managed conservatively. However, surgery should be considered in cases of unavailability or failure of conservative approaches.
A 34-year-old Gravid4Para3 pregnant woman in the 33rd week of gestation presented with refractory vaginal pain. She had a remarkable history of second-degree UP. Upon presentation, the anterior and posterior cervical lips were swollen, bluish, and protruding through the vagina. Considering the severe pain, the alarming examination findings, and the impossibility of pushing back the protruding mass, a total vaginal hysterectomy was performed. The postoperative pathological study revealed a massive hemorrhage with edematous changes in the vaginal cuff and cervical mucosa in addition to features of placenta accreta, placenta previa, and placenta abruption.
UP is a rare but potentially serious condition, especially if it is related to pregnancy. Moreover, managing UP could be challenging in low-income settings, where even simple conservative methods might be unavailable or financially unattainable.
子宫脱垂（UP）在孕期罕见。它有时会导致严重并发症，如流产、早产和孕产妇死亡。UP的主要危险因素是既往经阴道分娩，通常采用保守治疗。然而，在保守治疗方法不可行或失败的情况下应考虑手术治疗。
一名34岁、孕4产3的孕妇，孕33周，出现难治性阴道疼痛。她有显著的二度子宫脱垂病史。就诊时，宫颈前后唇肿胀、呈蓝色，经阴道突出。考虑到剧痛、令人担忧的检查结果以及无法将突出肿物回纳，遂行全阴道子宫切除术。术后病理研究显示，除胎盘植入、前置胎盘和胎盘早剥特征外，阴道断端及宫颈黏膜有大量出血伴水肿改变。
子宫脱垂是一种罕见但可能严重的病症，尤其是与妊娠相关时。此外，在低收入地区，管理子宫脱垂可能具有挑战性，因为即使是简单的保守方法也可能无法获得或在经济上难以承受。
