Pregnancy after the Manchester-Fothergill procedure: a case report

Cervical elongation is commonly associated with uterine prolapse. The Manchester-Fothergill procedure offers a fertility-preserving surgical option for its correction. However, conception following this procedure is exceedingly rare, with an estimated incidence of 1 in 10 000.

We present the case of a 35-year-old multiparous woman (G3P2L2) who conceived 18 months after undergoing the Manchester-Fothergill procedure for cervical elongation. Her obstetric history included one vaginal delivery and one cesarean section performed for cervical elongation. Postoperatively, she resumed regular menstrual cycles and later experienced an unplanned pregnancy.

The patient was managed with close antenatal surveillance, including serial sonographic evaluations of the cervical length and fetal well-being. She carried the pregnancy to term and delivered a healthy neonate via cesarean section at 39 weeks, with a birth weight of 3,700 grams. No evidence of prolapse recurrence was observed in the postpartum period.

This case highlights that, although rare, a successful pregnancy is possible following the Manchester-Fothergill procedure. Optimal outcomes depend on vigilant antenatal care, regular cervical monitoring, limitation of physical exertion, and early identification of potential complications.