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Pelvic organ prolapse complicating third trimester pregnancy. A case report
M Mutlu Meydanli1, Yusuf Ustün, Omer T Yalcin
1Department of Obstetrics and Gynecology, Turgut Ozal Medical Center, Inonu University School of Medicine, TR-44069 Malatya, Turkey.
Gynecologic and Obstetric Investigation
|December 2, 2005
Summary
This case report details a rare instance of severe pelvic organ prolapse during late pregnancy. A cesarean hysterectomy with abdominal sacrocolpopexy successfully treated the condition in a patient with completed family planning.
Area of Science:
- Obstetrics and Gynecology
- Pelvic Floor Disorders
- Surgical Management
Background:
- Concomitant third-trimester pregnancy and severe pelvic organ prolapse (POP) is exceptionally rare.
- Management options for this complex scenario are limited, especially in resource-constrained settings.
- This case highlights a unique surgical approach for a challenging clinical presentation.
Observation:
- A 30-year-old woman, gravida 6, parity 5, presented at 35 weeks gestation with uterine contractions and stage 3 pelvic organ prolapse.
- Pelvic examination confirmed significant prolapse in the dorsal lithotomy position.
- The patient had completed childbearing.
Findings:
- A concomitant cesarean hysterectomy was performed to deliver the fetus and remove the uterus.
- Following hysterectomy, an abdominal sacrocolpopexy was conducted to reconstruct the pelvic floor support.
- The vaginal cuff was successfully suspended to the sacral promontory.
Implications:
- Cesarean hysterectomy combined with abdominal sacrocolpopexy offers a viable surgical solution for severe POP complicating late pregnancy in women who have finished childbearing.
- This combined procedure addresses both obstetric and gynecologic needs simultaneously.
- The approach may be particularly relevant for improving maternal health outcomes in developing countries with limited healthcare access.