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báo cáo khoa học: "Two successful natural pregnancies in a patient with severe uterine prolapse: A case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Two successful natural pregnancies in a patient with severe uterine prolapse: A case report | De Vita and Giordano Journal of Medical Case Reports 2011 5 459 http www.jmedicalcasereports.eom content 5 1 459 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Two successful natural pregnancies in a patient with severe uterine prolapse A case report Davide De Vita1 and Salvatore Giordano2 Abstract Introduction Uterine prolapse is a common gynecologic condition that is rare during or before pregnancy. We report an exceptional case of two pregnancies in a totally prolapsed uterus. Case presentation A 36-year-old Caucasian woman with a history of uterine prolapse presented with pregnancy. A vaginal pessary was applied to keep her uterus inside the pelvis after manual reposition. The pessary was removed at the 24th week. The gravid uterus persisted in the abdominal cavity because of its increased volume. Conclusion Our case shows that pregnancy during uterine prolapse is possible and that careful assessment is required to prevent complications during delivery. According to our experience an elective caesarean section near term could be the safest mode of delivery. Introduction Uterine prolapse is a common gynecologic condition but it is extremely rare during pregnancy with an estimated incidence of one per 10 000 to 15 000 deliveries 1 . Few cases are described in the literature especially on its correlation with subsequent pregnancy. Women with prolapse may have a variety of pelvic floor symptoms. Symptoms include pelvic heaviness a dragging sensation in the vagina protrusion coming down from the vagina and backache but only some of these symptoms are directly related to the prolapse. Case presentation A 36-year-old Caucasian woman gravida 3 para 2 presented to our antenatal outpatient clinic in the 10th week of gestation complaining of uterine prolapse and amenorrhea. Five years earlier at the age of 31 years she had her first spontaneous vaginal delivery after 39 weeks of clinically unremarkable gestation and after a seven-hour labor. A living male baby .