Ba'Abbad Lina, Turki Marwa, Aldossary Ghada, Elzewawi Nouar, Saleem Heba Abu
Department of Obstetrics and Gynaecology, Faculty of Medicine, Princess Nourah Bint Abdulrahman University, Saudi Arabia.
Department of Obstetrics and Gynaecology, King Abdullah Bin Abdulaziz University Hospital, Saudi Arabia.
Case Rep Womens Health. 2023 Dec 16;41:e00578. doi: 10.1016/j.crwh.2023.e00578. eCollection 2024 Mar.
Uterine prolapse is a rare condition in pregnancy that may lead to serious antepartum, intrapartum and postpartum complications for the mother and fetus. This is the case of a 30-year-old woman who presented at 38 weeks of gestation of her third pregnancy with spontaneous rupture of membranes and labor pain. Pelvic examination in dorsal lithotomy position revealed a stage 3 uterine prolapse, with a 3 cm dilated thick edematous cervix and rupture of membranes with clear liquor. Four hours after admission, the cervix became more edematous and there had been no change in cervical dilatation. Therefore, advanced apical prolapse (negatively affecting labor) was diagnosed, and the obstetric team decided on a cesarean delivery because a lack of progression of cervical dilatation. A live female baby weighing 3400 g was delivered and no abnormal findings or complications were reported. The patient had uneventful postoperative course with a significant reduction in uterine prolapse. Six weeks post-delivery, assessment in the urogynecology outpatient clinic revealed spontaneous resolution of the prolapse. The woman was advised to perform pelvic floor muscle exercises and to seek medical advice if the condition recurred. Obstetricians should be aware of this rare condition in pregnancy, as proper early diagnosis is crucial for a safe, uneventful pregnancy.
子宫脱垂在孕期是一种罕见情况，可能会给母亲和胎儿带来严重的产前、产时及产后并发症。本文讲述了一名30岁女性的病例，她在第三次怀孕38周时出现胎膜自发破裂和宫缩痛。在膀胱截石位进行盆腔检查发现为3度子宫脱垂，宫颈扩张3厘米，增厚且水肿，胎膜破裂，羊水清。入院4小时后，宫颈水肿加重，宫颈扩张无变化。因此，诊断为重度子宫脱垂（影响产程），由于宫颈扩张无进展，产科团队决定行剖宫产。一名体重3400克的活产女婴出生，未报告有异常发现或并发症。患者术后恢复顺利，子宫脱垂明显减轻。产后六周，在泌尿妇科门诊评估发现脱垂自行缓解。建议该女性进行盆底肌肉锻炼，若病情复发需寻求医疗建议。产科医生应了解孕期这种罕见情况，因为早期正确诊断对于安全、顺利的妊娠至关重要。
