2025 Volume 21 Issue 1 Pages 18-25
Uterine prolapse during pregnancy is a rare condition that can significantly affect pregnancy outcomes. However, its clinical course and management are not well understood. In this report, we present the clinical course and management of two women who developed uterine prolapse during pregnancy. Additionally, we performed a literature review on the epidemiology, management, and mode of delivery for uterine prolapse during pregnancy. In the two pregnant women with uterine prolapse, we used a ring pessary with a thin diaphragm to prevent cervical protrusion through the ring. The antenatal and intrapartum periods of both the women progressed without severe complications such as preterm labor, infection, or trauma of the birth canal. We searched the Japanese database of the Journal of Health Care and Society using terms “uterine prolapse” AND “pregnancy” between the years 1985 and 2023 and identified 31 reported cases of uterine prolapse during pregnancy. Ring pessaries were administered to nine women and were effective to keep the uterus inside the pelvis in eight (89%) cases. Among 29 women with documented route of delivery, 20 (69%) delivered vaginally. The vaginal delivery rate was 87% in women who recovered from prolapse before delivery. Therefore, we recommend vaginal delivery for this population. Furthermore, we emphasize the effectiveness of ring pessary with thin diaphragm for cervical protrusion in pregnancy.
