Genital Prolapse at the End Term of Pregnancy: A Case Report Afaf Abdalla * Department of Obstetrics and Gynecology Nursing, Alneelain University, Sudan * Corresponding author: Afaf Abdalla, Department of Obstetrics and Gynecology Nursing, Alneelain University, Sudan, Tel: 00249912187802; E- mail: aabdalla642@gmail.com Rec date: May 31, 2017; Acc date: Aug 25, 2017; Pub date: Aug 30, 2017 Citaton: Abdalla A (2017) Genital Prolapse at the End Term of Pregnancy: A Case Report. Gynecol Obstet Case Rep Vol.3:No.2:54. Abstract Uterine prolapsed is a rare conditon occurs during pregnancy and lead to many complicatons. Usually conservatve treatment approached to use a vaginal pessary accompanied with bed rest. This current case exhibited obvious role of a vaginal pessary in restoring the prolapsed organ tll the tme of labor and may expect delivery at home. When studying the style of labor, Gynecologist should bear in their mind the cervical irritaton and edema. Along with the genital prolapsed which may afect normal vaginal delivery. Keywords: Uterine prolapse; Third trimester; Pregnancy; Vaginal pessary Introducton Uterine prolapse is a course of genital prolapsed, which happens when the uterus slips from its place into the vagina. Although the incidence rate of uterine prolapse has declined during the past decade in developed natons due to the gradual decrease in parity, approximately 50% of all adults who have delivered a near-term infant have some degree of clinically apparent genital prolapsed [1]. Genital prolapse is a conditon that can dramatcally afect quality of life causing specifc problems like inability to walk, sitng, lifing and bending [2]. Genital prolapse may start before labor. Nevertheless, in the most of cases, pregnancy has advertsed efect on a pre- existng prolapse. The concomitant phenomenon of a third trimester pregnancy with a signifcant level of pelvic organ prolapse is extremely rare [3]. Setlement of the prolapse in later weeks of pregnancy is expected as there is an increase in the uterine volume, which helps to posture on the pelvic brim. Now we discuss a case of a woman who presented with genital prolapsed before to deliver her child. Case Report A 28-year-old lady pregnant four tmes, Para 3, living 2 presented at 36 weeks of gestaton, she complains with from low backache, abdominal pain and a mass in her vagina for 3 days. In her current pregnancy was complicated from the beginning and second trimesters. She found a mass per vagina, which appears suddenly. She had no history of chronic constpaton, lifing heavy objects or chronic cough. When we do a physical examinaton of the reproductve tract system, observed that the lower part of the uterus gets out. The cervix of the uterus was bulging and appear afer the vaginal opening, but easily to return back to it is the normal positon. The cervical OS was closed and other systems were normal. Ultrasound shows normal cervical anatomy. Therefore, she was admited to the hospital and the protruding part was returning back without surgical interventon. She was given antbiotcs, intravenous Betamethasone (12 mg, two tmes with 12 hours apart) and to contnue on prophylactc tocolytc, per oral every 8 hours daily for one week and was counseled about importance of bed rest at home. Afer four weeks, she had an uneventul normal vaginal delivery at home and the protruding part return without interventon. She came back on the 25th day afer delivery with the appearance of the mass for the second tme. On testng the lower uterine part was outside the vaginal opening and the uterus was of appropriate measurement. We did not fnd any puerperal infecton elsewhere. The patent was moved over a regime of antbiotc tabs, as well as iron and advised for Sling operaton plus tubal ligaton afer puerperium. Discussion Protrusion of the uterus not more occur during gestaton nevertheless happened more common in non-pregnant elderly women. It may develop for the frst tme during gestaton, but in the most of conditon, pregnancy could consider a direct cause of prolapsed uterus. When more or less stage of protrusion is found prior gestaton, commonly contnues tll the pregnancy advance to a stage where spontaneous reducible occurs. In many conditons, a symptom of the prolapsed happens in the last trimester, if it takes place at the beginning of the pregnancy, can resolve afer labor and delivery spontaneously. Case Report iMedPub Journals www.imedpub.com DOI: 10.21767/2471-8165.1000054 Gynecology & Obstetrics Case Report ISSN 2471-8165 Vol.3 No.2:54 2017 © Copyright iMedPub | This article is available from: http://gynecology-obstetrics.imedpub.com/ 1