Abstract
Pelvic organ prolapse complicating pregnancy is a rare clinical condition and its incidence is one in 10,000~15,000 deliveries. It is associated with multiparity, low socioeconomic status, inadequate perinatal care, maternal malnutrition, previous abdominal surgery, and weakness of pelvic muscular and connective tissue. It can cause cervical dystocia, which leads to cervical laceration, uterine rupture, maternal and fetal death. We experienced a case, first in Korea, of cervical swelling that developed during labor, prolapsed beyond the vaginal introitus and thus obstructed the birth canal. The patient underwent cesarean section and subsequently received MgSO4 topical therapy and resulted in complete resolution. We report this case with a brief review of literature.
Figures and Tables
Fig. 1
The 3rd stage pelvic organ prolapse: photograph showing the edematous anterior cervical lip (A). Cervical opening is noted when speculum is inserted posterior to the mass (B) but not when anterior to it (C).
![kjog-53-727-g001](/upload/SynapseData/ArticleImage/0021kjog/kjog-53-727-g001.jpg)
References
1. Keettel WC. Prolapse of the uterus during pregnancy. Am J Obstet Gynecol. 1941. 42:121–126.
2. Kibel I. Pregnancy at term in prolapsed uterus. Am J Obstet Gynecol. 1944. 47:703–704.
3. Lee KB, Yoo SK, Kim YC, Park IS. A case of uterine prolapse during pregnancy. Korean J Obstet Gynecol. 1981. 24:569–571.
4. Kim DH, Lee HJ, Kim HC, Jung HS, Shon JS. A case of a full term pregnancy in association with the total uterine prolapse. Korean J Obstet Gynecol. 1972. 15:601–603.
5. Mun ST, Kim YS, Jeon S, Choi SD, Sunwoo JG, Bae DH. Uterine prolapse complicating pregnancy. Korean J Obstet Gynecol. 2008. 51:1034–1037.
6. Yi MH, Park JW. A case report of cervical prolapse complicating pregnancy. Korean J Obstet Gynecol. 2000. 43:1273–1275.
7. Chandru S, Srinivasan J, Roberts AD. Acute uterine cervical prolapse in pregnancy. J Obstet Gynaecol. 2007. 27:423–424.
8. Gass ML. Does abdominoplasty predispose to pelvic relaxation? Plast Reconstr Surg. 1990. 86:1240–1241.
9. Brown HL. Cervical prolapse complicating pregnancy. J Natl Med Assoc. 1997. 89:346–348.
10. Meydanli MM, Ustun Y, Yalcin OT. Pelvic organ prolapse complicating third trimester pregnancy. A case report. Gynecol Obstet Invest. 2006. 61:133–134.
11. Horowitz ER, Yogev Y, Hod M, Kaplan B. Prolapse and elongation of the cervix during pregnancy. Int J Gynaecol Obstet. 2002. 77:147–148.
12. Hill PS. Uterine prolapse complicating pregnancy. A case report. J Reprod Med. 1984. 29:631–633.
13. Sawyer D, Frey K. Cervical prolapse during pregnancy. J Am Board Fam Pract. 2000. 13:216–218.
14. Sit A, Fu H. To push or not to push? The patient had not disclosed a problem that would complicate labor. Am J Obstet Gynecol. 2009. 201:120.e1.
15. Lau S, Rijhsinghani A. Extensive cervical prolapse during labor: a case report. J Reprod Med. 2008. 53:67–69.
16. Piver MS, Spezia J. Uterine prolapse during pregnancy. Obstet Gynecol. 1968. 32:765–769.
17. Baxi LV, Walsh CA. Topical magnesium sulfate for cervical dystocia. J Reprod Med. 2009. 54:189–190.
18. Palanichamy G. Prolapse of the uterus complicating labour (A study of 38 cases). J Obstet Gynaecol India. 1976. 26:692–697.