Cervical Prolapse in a term Multigravid Woman - A case report

Abstract

Cervical prolapsed is a rare condition encountered in     pregnancy with an estimated incidence of 1 per 1  5,000-20,000 deliveries. We present a case report of a   26-year old woman gravida 3 para 2 live 2 with cervical prolapse admitted in our hospital with labour pains at 39^th week of gestation. Cesarean section was performed because of severe edematous and ulcerated cervix. Post  natally   cervical prolapse spontaneously recovered. Prompt diagnosis and effective management is required in this rare entity.     Cesarean section is preferred in case of severe edematous and ulcerated cervix. KEYWORDS: Cervical prolapse, third trimester,ulcerated, edematous

Case report   A 26-year old woman gravida 3 para 2 live 2 with previous spontaneous vaginal deliveries admitted in our hospital with labour pains at 39^th week of gestation. There was no        significant past obstetric history of obstructed labour and macrosomia. Ultrasonic examination revealed a single live intrauterine fetus in cephalic presentation with an estimated fetal weight of 2.5 kg.On examination, she had regular uterine contractions associated with a cervical dilatation of 1-2 cm and effacement 25%. Cervix was found to be irreducible and dessicated (Fig 1). There was minimal bleeding because of erosed and dessicated cervix. When cervical dilatation      approached to 2-3 cm with an effacement of 50%, bleeding was profound. As there was associated tachycardia and   hypotension because of increased bleeding, emergency   cesarean section was performed. An alive boy baby with birth weight of 2.6 kg with apgar score 9 was born .

 Conclusion  Cervical prolapse observed during pregnancy is a rare condition and no guideline has been published regarding its management till date. The decision regarding its mode of delivery poses a serious challenge and it is to be      individualized depending on gestation, severity of prolapse and patient’s choice. Although no presenting risk factors was reported  in our case, prompt diagnosis and effective management is required in this rare entity. Cesarean   section may be preferred and has found to be the safest option in case of severe edematous and ulcerated cervix.