Uterine prolapse, a condition where the uterus descends from its normal position, can present unique considerations during pregnancy. While generally more common in older women or those who have had multiple vaginal deliveries, it can occur or worsen during gestation. This article clarifies how uterine prolapse might affect pregnancy, covering symptoms, its influence on labor and delivery, and available management approaches.
Understanding Uterine Prolapse
Uterine prolapse occurs when the muscles, ligaments, and tissues of the pelvic floor weaken, causing the uterus to drop into the vaginal canal. These supporting structures hold the uterus, bladder, and bowel in their proper positions within the pelvis. When this support system becomes compromised, the uterus can descend to varying degrees, from a slight drop to protruding outside the vaginal opening. Pregnancy and childbirth are significant factors that can weaken these pelvic floor supports.
Prolapse During Pregnancy
A uterine prolapse can manifest with various symptoms during pregnancy, influenced by the increasing weight of the growing uterus. Many pregnant individuals experience a sensation of heaviness, pressure, or fullness in the pelvis. Some may also feel a bulge or the sensation of something “falling out” of the vagina. These feelings can intensify with activity or prolonged standing.
The condition can lead to urinary issues, such as frequent urination, difficulty emptying the bladder, or urinary incontinence. This occurs because the prolapsed uterus can alter the bladder’s position. Bowel movements might also become challenging, with some individuals experiencing constipation or needing to strain. While severe complications are rare, untreated prolapse during pregnancy can sometimes lead to cervical infections or, less commonly, preterm labor.
Prolapse During Labor and Delivery
Uterine prolapse can influence the birthing process, though many women with the condition still have successful vaginal deliveries. One potential impact is on cervical effacement and dilation, particularly if the cervix is significantly prolapsed and becomes edematous (swollen). This swelling can sometimes hinder the natural progression of labor. Medical evaluation and close monitoring are important to assess the cervix’s position and readiness for labor.
While vaginal delivery is often feasible, a cesarean section might be considered in specific situations, such as severe prolapse obstructing the birth canal, or if other complications arise. Obstructed labor due to severe prolapse is rare but can occur. Healthcare providers will assess each individual’s situation to determine the safest delivery method, prioritizing maternal and fetal well-being.
Managing Prolapse in Pregnancy
Management of uterine prolapse during pregnancy primarily focuses on alleviating symptoms and preventing complications through conservative measures. Pelvic floor exercises, sometimes called Kegels, can help strengthen the supporting muscles and improve symptoms. A healthcare provider or a pelvic floor physiotherapist can provide guidance on performing these exercises correctly.
Another common strategy involves a vaginal pessary, a removable device inserted into the vagina to provide support to the uterus. A healthcare professional can help find the most suitable one. Regular medical monitoring by an obstetrician is important to track the prolapse’s progression and adjust management as needed.
Many women manage their condition effectively for healthy pregnancies and deliveries. While prolapse may persist after delivery, the focus during pregnancy is on conservative management for a safe outcome.