First-time presentation of acute uterine prolapse in third trimester of pregnancy: a case report

Uterine prolapse that develops before onset of pregnancy will usually resolve spontaneously by the end of the second trimester of pregnancy without further complications, whereas prolapse that develops during pregnancy is usually first noted in the third trimester of pregnancy. A 28-year-old woman, gravida 3 para 2 (both vaginal delivery), presented with a history of mass protrusion per vagina of 6 hours duration at a gestational age of 34 6/7 weeks of gestation. On physical examination, a complete prolapse of the cervix through the vagina was noted, with part of the lower uterine segment in the vaginal canal. Pelvic ultrasound confirmed the prolapse, with report of part of the lower uterine segment in the vaginal canal. With an assessment of acute uterine prolapse, the patient was placed in a moderately Trendelenburg position, and the prolapse was reduced manually. The cervix was repositioned into the vagina and packed with sterile gauze soaked in saline. Acute presentation of uterine prolapse in the third trimester of pregnancy for the first time is a very rare occurrence. If encountered, a conservative approach that aims at replacing the prolapse back to its position, allowing the cervical edema to subside, should be performed.