Sium Abraham Fessehaye, Abdu Amani Nureddin, Kitila Hika Hailu, Urgie Tadesse
Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
AJOG Glob Rep. 2025 Jul 8;5(3):100543. doi: 10.1016/j.xagr.2025.100543. eCollection 2025 Aug.
Uterine prolapse that develops before onset of pregnancy will usually resolve spontaneously by the end of the second trimester of pregnancy without further complications, whereas prolapse that develops during pregnancy is usually first noted in the third trimester of pregnancy. A 28-year-old woman, gravida 3 para 2 (both vaginal delivery), presented with a history of mass protrusion per vagina of 6 hours duration at a gestational age of 34 6/7 weeks of gestation. On physical examination, a complete prolapse of the cervix through the vagina was noted, with part of the lower uterine segment in the vaginal canal. Pelvic ultrasound confirmed the prolapse, with report of part of the lower uterine segment in the vaginal canal. With an assessment of acute uterine prolapse, the patient was placed in a moderately Trendelenburg position, and the prolapse was reduced manually. The cervix was repositioned into the vagina and packed with sterile gauze soaked in saline. Acute presentation of uterine prolapse in the third trimester of pregnancy for the first time is a very rare occurrence. If encountered, a conservative approach that aims at replacing the prolapse back to its position, allowing the cervical edema to subside, should be performed.
妊娠前发生的子宫脱垂通常在妊娠中期结束时会自行缓解，不会出现进一步并发症，而在妊娠期间发生的脱垂通常在妊娠晚期首次被注意到。一名28岁女性，孕3产2（均为阴道分娩），在妊娠34 6/7周时出现阴道肿物突出6小时的病史。体格检查发现宫颈完全经阴道脱出，部分子宫下段位于阴道管内。盆腔超声证实了脱垂，报告显示部分子宫下段位于阴道管内。经评估为急性子宫脱垂，患者被置于适度头低脚高位，并手动将脱垂复位。宫颈被重新放置回阴道并用浸有生理盐水的无菌纱布填塞。妊娠晚期首次急性出现子宫脱垂是非常罕见的情况。如果遇到这种情况，应采取保守方法，旨在将脱垂复位，使宫颈水肿消退。
