Management of pelvic organ prolapse during pregnancy: Case report

Abstract

During pregnancy, pelvic organ prolapse is uncommon and is associated with adverse outcomes such as vaginal infection, cervical ulceration, and preterm delivery. Treatment includes conservative and surgical management during pregnancy. A 32-year-old woman presented with a history of vaginal delivery eight months earlier reported the sensation of a vaginal mass lasting seven months. On physical examination, we noted pelvic organ prolapse and 19-week pregnancy. We treated her conservatively with a Gellhorn pessary and antenatal corticosteroid for fetal lung maturation at 32 weeks due to a high risk of preterm delivery. The pregnancy proceeded with no obstetric complications and vaginal delivery at term of a healthy neonate. Conservative management for patients with pelvic organ prolapse during pregnancy using a pessary is the best option to improve maternal symptomatology and minimize gestational risk; there is no contraindication for vaginal delivery, and cesarean section is reserved for obstetric indications.

Keywords

• High-risk pregnancy
• Pelvic organ prolapse
• Pregnancy
• Uterine prolapse
• Vaginal ring pessary