PREGNANCY AND CHILDBIRTH WITH GENITAL PROLAPSE: A CLINICAL CASE

Abstract

Relevance: Pelvic floor dysfunction is one of the most pressing issues in women’s health and quality of life. Pelvic prolapse occurs in 30-50% of women who have given birth. Although this pathology is not life-threatening, it significantly complicates the woman’s quality of life. Genital prolapse (GP) occurs due to insufficient pelvic floor support. It should be noted that the pelvic diaphragm structures are constantly under dynamic overload, resulting in ligament ruptures. However, it is known that not only mechanical damage causes the collapse of the pelvic organs. Today, GP is considered a chronic pathology of the extracellular matrix. The purpose was to raise the clinical awareness of the medical community about genital prolapse and its manifestations during pregnancy. Methods: The study examined sources on GP pathogenesis, diagnosis, and treatment, including during pregnancy and the possibilities of vaginal delivery, and analyzed medical documentation on a GP clinical case during pregnancy. Results: The article reviews recent publications on GP-associated pregnancy and childbirth peculiarities and modern views on GP classification and risk factors for GP development. The article describes a clinical case of pregnancy with a stage III GP. Its outcome showed the effectiveness of the chosen treatment tactics using a perforated obstetric pessary and magnesium and progesterone preparations and proved the possibility of vaginal childbirth in this pathology. Conclusion: The reported clinical case of GP during pregnancy confirms the published literature data on GP risk factors, including low BMI, permanent physical activity, and the presence in the birth history of large fetuses with numerous injuries to soft tissues canal. The chosen treatment tactics were based on the current regulations on treating pelvic floor dysfunction patients, including the use of cervical pessaries, and the authors’ research and clinical experience in managing pregnant women with undifferentiated connective tissue dysplasia and isthmic cervical insufficiency.