TY - JOUR
T1 - A case report of successful vaginal delivery in a patient with severe uterine prolapse and a review of the healing process of a cervical incision
AU - Maki, Jota
AU - Mitoma, Tomohiro
AU - Mishima, Sakurako
AU - Ohira, Akiko
AU - Tani, Kazumasa
AU - Eto, Eriko
AU - Hayata, Kei
AU - Masuyama, Hisashi
N1 - Funding Information:
We thank the obstetrics surgeons and other healthcare personnel involved in the treatment of patients at the Department of Obstetrics and Gynecology, Okayama University Hospital. The authors declare that they have no conflict of interest regarding the publication of this case report.
Publisher Copyright:
© 2021 The Authors
PY - 2022/1
Y1 - 2022/1
N2 - Background: The incidence of severe uterine prolapse during childbirth is approximately 0.01%. Moreover, to the best of our knowledge, no reports detail the healing process of the cervix during uterine involution. This report describes successful vaginal delivery and the healing process of postpartum uterine prolapse and cervical tears in a patient with severe uterine prolapse. Case presentation: A patient in her 40s (gravida 3, para 1, abortus 1) with severe uterine prolapse successfully delivered a live female baby weighing 3190 g at 38 + 5 weeks of gestation by assisted vaginal delivery. Uterine prolapse had improved to approximately 2° by 2 months postoperatively. On postpartum day 4, during the healing process of cervical laceration, the thread loosened in a single layer of continuous sutures due to uterine involution, and poor wound healing was observed. The wound was subsequently re-sutured with a two-layer single ligation suture (Gambee suture + vertical mattress suture). However, on postpartum day 11, a large thread ball was hindering the healing of the muscle layer, which improved with re-suturing. Conclusion: Although vaginal delivery in a patient with severe uterine prolapse is possible in some cases, the cervix should be sutured, while considering cervical involution after delivery.
AB - Background: The incidence of severe uterine prolapse during childbirth is approximately 0.01%. Moreover, to the best of our knowledge, no reports detail the healing process of the cervix during uterine involution. This report describes successful vaginal delivery and the healing process of postpartum uterine prolapse and cervical tears in a patient with severe uterine prolapse. Case presentation: A patient in her 40s (gravida 3, para 1, abortus 1) with severe uterine prolapse successfully delivered a live female baby weighing 3190 g at 38 + 5 weeks of gestation by assisted vaginal delivery. Uterine prolapse had improved to approximately 2° by 2 months postoperatively. On postpartum day 4, during the healing process of cervical laceration, the thread loosened in a single layer of continuous sutures due to uterine involution, and poor wound healing was observed. The wound was subsequently re-sutured with a two-layer single ligation suture (Gambee suture + vertical mattress suture). However, on postpartum day 11, a large thread ball was hindering the healing of the muscle layer, which improved with re-suturing. Conclusion: Although vaginal delivery in a patient with severe uterine prolapse is possible in some cases, the cervix should be sutured, while considering cervical involution after delivery.
KW - Complete uterine prolapse
KW - Pregnancy
KW - Scars
KW - Suture techniques
KW - Vaginal delivery
UR - http://www.scopus.com/inward/record.url?scp=85121331222&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85121331222&partnerID=8YFLogxK
U2 - 10.1016/j.crwh.2021.e00375
DO - 10.1016/j.crwh.2021.e00375
M3 - Article
AN - SCOPUS:85121331222
SN - 2214-9112
VL - 33
JO - Case Reports in Women's Health
JF - Case Reports in Women's Health
M1 - e00375
ER -