Obstetric and postpartum result of elongatio colli during pregnancy

Objective

Uterine prolapsus is a gynecologic problem that seen in elderly and multiparous women. In literature it is mentioned that occasionally uterine prolapsus with elongation colli is seen after delivery. Etiology of uterine prolapsus after delivery is increased hormone levels (esp. progesterone and cortizole) during pregnancy may cause relaxation of uterine supporting ligaments (cardinal, uterosacrale).We follow our patient pre and post partum period and observe spontaneous recovery of uterine prolapsus and elongation colli at post partum period.

Case(s)

Our case is 37 years old, multiparous woman who is complaining about pain in her 33th week of gestation. At her history, she delivered 2850 gr term healthy baby with normal vaginal delivery and after the labor her complains about the mass protruding from introitus was started. But she did not get any treatment about this mass after the labor.
Patients elongation colli was protruded from intraitus about 10-12 cm and reductable by hand (POP Q 3) and her cervical examination was multiparous and also heavy erosion due to the mechanical trauma was seen. We treated her preterm labour condition fistly and than gave her pesser treatment with antibiotheraphy and get cervical cytology because of her cervical erosion. we followed the patient at bed rest due to the failure of pesser treatment. (Figure 1)
She delivered 3050 gr healthy baby with cesarian section. She has no complication at postpartum period. We recommended surgery for her condition bu she refuse the surgery. (Figure 2)

Conclusion and Results

In most cases, women were multiparous and their prolapsus condition was seen before the pregnancies.
Pregnancy complications as abortion, preterm labour and urinary infection are seen in these women. Also labour complications as arrestment of labour and dystocia due to cervical hypertrophia because of edema and infection of cervix are also seen. Due to the fact thas elective cesarian section is recommended for these patients. Psotpsrtum atonia bleeding is also seen often in this prolapsus patients and its morbidity is also very high.
In literature, spontaneous recovery of uterine prolapsus and elongation colli was seen rarely. But mostly the spontaneous recovery of the condition is not seen and surgery at postpartum period is recommended.
In our patient, due to the Kegel exercise the prolapsus and ellongatio colli degree was not recovered, and difficulty in reduction was occurred. We offered surgery but she refused it due to financial issues.

Keywords

Pregnancy, uterine prolapsus, elongatio colli

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	File/Dsecription
	Figure 1 Elongatio colli during pregnancy
	Figure 2 Elongatio colli during postpartum period