METHODS: The patient\'s reproductive history included an abortion and eutocic delivery of a girl weighing 3200 g; the current pregnancy was the third pregnancy. Her cervical region was outside the vaginal opening and was red in color, with evident enlargement (6 × 4 cm) and a broken surface. The cervical area also showed white discharge. According to her Transvaginal ultrasonography revealed a fetus in the uterine cavity at approximately 19 weeks of gestation. Gynecological examination revealed prolapse of both the anterior and posterior vaginal walls. Evaluation of the pelvic organ prolapse-Q scores showed that the patient had uterine prolapse at stage IV.
RESULTS: Vaginal delivery was performed smoothly after oral administration mifepristone and misoprostol tablets for a few days, obtaining a dead female fetus in cephalic, 25 cm in length. The cervix of the pregnant woman did not prolapse during the delivery.
CONCLUSIONS: For pregnancy with uterine prolapse and cervical incarceration, transvaginal delivery is a potential treatment option. Maintenance of cervical retraction and oral mifepristone administration with misoprostol tablets is crucial during this delivery. This treatment can minimize the risk of cervical lacerations and uterine rupture, helping surgeons to complete the operation successfully.
方法:患者的生殖史包括流产和重达3200g的女孩的正常分娩;当前的妊娠是第三次妊娠。她的宫颈区域在阴道口外,呈红色,有明显的扩大(6×4厘米)和破碎的表面。宫颈区域也显示白色分泌物。根据她的经阴道超声检查显示,在妊娠约19周时,子宫腔中有胎儿。妇科检查显示阴道前后壁脱垂。对盆腔器官脱垂Q评分的评估表明,患者在IV期患有子宫脱垂。
结果:口服米非司酮和米索前列醇片几天后,阴道分娩顺利进行,在头部获得一个死去的女性胎儿,25厘米的长度。孕妇的子宫颈在分娩期间没有脱出。
结论:妊娠合并子宫脱垂和宫颈嵌顿,经阴道分娩是一种潜在的治疗选择。在分娩过程中,维持宫颈回缩和口服米索前列醇片的米非司酮给药至关重要。这种治疗可以最大限度地减少宫颈撕裂和子宫破裂的风险,帮助外科医生成功完成手术。