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Chapter 6 - Vaginal Prolapse and Previous Prolapse Surgery

Published online by Cambridge University Press:  14 July 2023

By
Swati Jha
Edited by
Swati Jha  and
Priya Madhuvrata
Swati Jha
Affiliation:
Sheffield Teaching Hospital NHS Foundation Trust
Priya Madhuvrata
Affiliation:
Sheffield Teaching Hospital NHS Foundation Trust
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Summary

Pelvic organ prolapse is a common gynaecological problem and often requires surgical management. It is therefore inevitable that vaginal prolapse will also be encountered in pregnancy. Antepartum prolapse is managed conservatively with pessaries and physiotherapy, though occasionally more active surgical intervention will be required. Intrapartum complications in women going into labour with a prolapse are uncommon, however may occur and the commonest problems encountered are cervical dystocia and cervical lacerations. Mode of delivery remains controversial. Women usually have a recurrence of prolapse post-natally and treatment needs to be tailored to patient preferences.

Keywords

pregnancypelvic organ prolapseprolapsevaginal prolapsecervical prolapseuterine prolapse
Type
Chapter
Information
Gynaecology for the Obstetrician , pp. 50 - 60
Publisher: Cambridge University Press
Print publication year: 2023

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References

Liang, C. C., Tseng, L. H., Horng, S. G., Lin, I. W. and Chang, S. D.. Correlation of pelvic organ prolapse quantification system scores with obstetric parameters and lower urinary tract symptoms in primiparae postpartum. International Urogynecology Journal and Pelvic Floor Dysfunction, 18 (2007), 537–41.CrossRefGoogle ScholarPubMed
Ishida, H., Takahashi, K. and Kurachi, H.. Uterine prolapse during late pregnancy in a nulliparous woman. International Urogynecology Journal, 25 (2014), 1739–40.Google Scholar
O’Boyle, A. L., Woodman, P. J., O’Boyle, J. D., Davis, G. D. and Swift, S. E.. Pelvic organ support in nulliparous pregnant and nonpregnant women: A case control study. American Journal of Obstetrics and Gynecology, 187 (2002), 99–102.Google Scholar
Gyhagen, M., Bullarbo, M., Nielsen, T. F. and Milsom, I.. Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth: A national cohort study in singleton primiparae after vaginal or caesarean delivery. British Journal of Obstetrics & Gynaecology, 120 (2013), 152–60.Google Scholar
DeLancey, J. O., Morgan, D. M., Fenner, D. E., et al. Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse. Obstetrics & Gynecology, 109 (2007), 295–302.Google Scholar
Kearney, R., Miller, J. M., Ashton-Miller, J. A. and DeLancey, J. O.. Obstetric factors associated with levator ani muscle injury after vaginal birth. Obstetrics & Gynecology, 107 (2006), 144–9.CrossRefGoogle ScholarPubMed
Kearney, R., Fitzpatrick, M., Brennan, S., et al. Levator ani injury in primiparous women with forceps delivery for fetal distress, forceps for second stage arrest, and spontaneous delivery. International Journal of Gynaecology and Obstetrics, 111 (2010), 19–22.CrossRefGoogle ScholarPubMed
Mant, J., Painter, R. and Vessey, M.. Epidemiology of genital prolapse: Observations from the Oxford Family Planning Association Study. British Journal of Obstetrics and Gynaecology, 104 (1997), 579–85.Google Scholar
Nygaard, I., Bradley, C. and Brandt, D.. Pelvic organ prolapse in older women: Prevalence and risk factors. Obstetrics & Gynecology, 104, (2004), 489–97.Google Scholar
Glazener, C., Elders, A., Macarthur, C., et al. Childbirth and prolapse: Long-term associations with the symptoms and objective measurement of pelvic organ prolapse. British Journal of Obstetrics and Gynaecology, 120 (2013),161–8.Google ScholarPubMed
Horowitz, E. R., Yogev, Y., Hod, M. and Kaplan, B.. Prolapse and elongation of the cervix during pregnancy. International Journal of Gynaecology and Obstetrics, 77 (2002), 147–8.Google Scholar
Keettel, W. C.. Prolapse of uterus during pregnancy. American Journal of Obstetrics and Gynecology, 42 (1941), 21–6.Google Scholar
Sze, E. H., Sherard, G. B. III and Dolezal, J. M.. Pregnancy, labor, delivery, and pelvic organ prolapse. Obstetrics & Gynecology, 100 (2002), 981–6.Google Scholar
Mohamed-Suphan, N. and Ng, R. K.. Uterine prolapse complicating pregnancy and labor: A case report and literature review. International Urogynecology Journal, 23 (2012), 647–50.CrossRefGoogle ScholarPubMed
Asali, F., Mahfouz, I. and Phillips, C.. The management of urogynaecological problems in pregnancy and the early postpartum period. Obstetrics & Gynecology, 14 (2012), 153–8.Google Scholar
Romeikiene, K. E. and Bartkeviciene, D.. Pelvic-floor dysfunction prevention in prepartum and postpartum periods. Medicina (Kaunas), 57 (2021), 387.Google ScholarPubMed
Piver, M. S. and Spezia, J.. Uterine prolapse during pregnancy. Obstetrics & Gynecology, 32 (1968), 765–9.Google Scholar
Sawyer, D. and Frey, K.. Cervical prolapse during pregnancy. Journal of the American Board of Family Practice, 13 (2000), 216–18.Google Scholar
Yogev, Y., Horowitz, E. R., Ben Haroush, A. and Kaplan, B.. Uterine cervical elongation and prolapse during pregnancy: An old unsolved problem. Clinical and Experimental Obstetrics & Gynecology, 30 (2003), 183–5.Google Scholar
Matsumoto, T., Nishi, M., Yokota, M. and Ito, M.. Laparoscopic treatment of uterine prolapse during pregnancy. Obstetrics & Gynecology, 93 (1999), 849.Google ScholarPubMed
Pradhan, A., Tincello, D. G. and Kearney, R.. Childbirth after pelvic floor surgery: Analysis of Hospital Episode Statistics in England, 2002–2008. British Journal of Obstetrics and Gynaecology, 120 (2013), 200–4.Google ScholarPubMed
Barranger, E., Fritel, X. and Pigne, A.. Abdominal sacrohysteropexy in young women with uterovaginal prolapse: Long-term follow-up. American Journal of Obstetrics and Gynecology, 189 (2003), 1245–50.Google Scholar
Busby, G. and Broome, J.. Successful pregnancy outcome following laparoscopic sacrohysteropexy for second degree uterine prolapse. Gynecological Surgery, 7 (2010), 271–3.CrossRefGoogle Scholar
Lewis, C. M. and Culligan, P.. Sacrohysteropexy followed by successful pregnancy and eventual reoperation for prolapse. International Urogynecology Journal, 23 (2012), 957–9.Google Scholar
Fisher, J. J.. The effect of amputation of the cervix uteri upon subsequent parturition: A preliminary report of seven cases. American Journal of Obstetrics and Gynecology, 62 (1951), 644–8.Google Scholar
Kumtepe, Y., Cetinkaya, K. and Karasu, Y.. Pregnancy and delivery after anterior vaginal mesh replacement: A case presentation. International Urogynecology Journal, 24 (2013), 345–7.Google Scholar
Pantha, S.. Repeated pregnancy in a woman with uterine prolapse from a rural area in Nepal. Reproductive Health Matters, 19 (2011), 129–32.CrossRefGoogle Scholar
Yousaf, S., Haq, B. and Rana, T.. Extensive uterovaginal prolapse during labor. Journal of Obstetrics and Gynaecology Research, 37 (2011), 264–6.Google Scholar
Partsinevelos, G. A., Mesogitis, S., Papantoniou, N. and Antsaklis, A.. Uterine prolapse in pregnancy: A rare condition an obstetrician should be familiar with. Fetal Diagnosis and Therapy, 24 (2008), 296–8.CrossRefGoogle Scholar
Cingillioglu, B., Kulhan, M. and Yildirim, Y.. Extensive uterine prolapse during active labor: A case report. International Urogynecology Journal, 21 (2010), 1433–4.Google Scholar
Meydanli, M. M., Ustun, Y. and Yalcin, O. T.. Pelvic organ prolapse complicating third trimester pregnancy. A case report. Gynecologic and Obstetric Investigation, 61 (2006), 133–4.Google Scholar
Karatayli, R., Gezginc, K., Kantarci, A. H. and Acar, A.. Successful treatment of uterine prolapse by abdominal hysteropexy performed during Cesarean section. Archives of Gynecology and Obstetrics, 287 (2013), 319–22.Google Scholar
Guariglia, L., Carducci, B., Botta, A., Ferrazzani, S. and Caruso, A.. Uterine prolapse in pregnancy. Gynecologic and Obstetric Investigation, 60 (2005), 192–4.Google Scholar
Pandey, K., Arya, S. and Pande, S.. Pregnancy with uterine prolapse: Dührssen’s incision still valid in today’s scenario? International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2 (2013), 586–90.CrossRefGoogle Scholar
Brown, H. L.. Cervical prolapse complicating pregnancy. Journal of the National Medical Association, 89 (1997), 346–8.Google Scholar
Lau, S. and Rijhsinghani, A.. Extensive cervical prolapse during labor: A case report. Journal of Reproductive Medicine, 53 (2008), 67–9.Google ScholarPubMed
Kart, C., Aran, T. and Guven, S.. Stage IV C prolapse in pregnancy. International Journal of Gynaecology & Obstetrics, 112 (2011), 142–3.Google Scholar
Chandru, S., Srinivasan, J. and Roberts, A. D.. Acute uterine cervical prolapse in pregnancy. Journal of Obstetrics and Gynaecology, 27 (2007), 423–4.Google Scholar
Daskalakis, G., Lymberopoulos, E., Anastasakis, E., et al. Uterine prolapse complicating pregnancy. Archives of Gynecology and Obstetrics, 276 (2007), 391–2.CrossRefGoogle ScholarPubMed
Wieslander, C. K., Weinstein, M. M., Handa, V. L. and Collins, S. A.. Pregnancy in women with prior treatments for pelvic floor disorders. Female Pelvic Medicine and Reconstructive Surgery, 26 (2020), 299–305.Google Scholar
Kow, N., Goldman, H. B. and Ridgeway, B.. Uterine conservation during prolapse repair: 9-year experience at a single institution. Female Pelvic Medicine and Reconstructive Surgery, 22 (2016), 126–31.Google Scholar
Maher, C. F., Carey, M. P. and Murray, C. J.. Laparoscopic suture hysteropexy for uterine prolapse. Obstetrics and Gynecology, 97 (2001), 1010–14.Google Scholar
Hefni, M. and El-Toukhy, T.. Sacrospinous cervico-colpopexy with follow-up 2 years after successful pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology, 103 (2002), 188–90.Google Scholar
Kovac, S. R. and Cruikshank, S. H.. Successful pregnancies and vaginal deliveries after sacrospinous uterosacral fixation in five of nineteen patients. American Journal of Obstetrics and Gynecology, 168 (1993), 1778–83.Google Scholar
Bo, K., Hilde, G., Staer-Jensen, J., et al. Postpartum pelvic floor muscle training and pelvic organ prolapse. American Journal of Obstetrics and Gynecology, 212 (2015), e1–7.CrossRefGoogle ScholarPubMed
Lin, L. L., Ho, M. H., Haessler, A. L., et al. A review of laparoscopic uterine suspension procedures for uterine preservation. Current Opinion in Obstetrics and Gynecology, 17 (2005), 541–6.Google Scholar
Cutner, A., Kearney, R. and Vashisht, A.. Laparoscopic uterine sling suspension: A new technique of uterine suspension in women desiring surgical management of uterine prolapse with uterine conservation. British Journal of Obstetrics and Gynaecology, 114 (2007), 1159–62.Google ScholarPubMed
Seracchioli, R., Hourcabie, J. A., Vianello, F., et al. Laparoscopic treatment of pelvic floor defects in women of reproductive age. Journal of the American Association of Gynecologic Laparoscopists, 11 (2004), 332–5.CrossRefGoogle ScholarPubMed

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