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

Jota Maki, Tomohiro Mitoma, Sakurako Mishima, Akiko Ohira, Kazumasa Tani, Eriko Eto, Kei Hayata, Hisashi Masuyama

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Article numbere00375
JournalCase Reports in Women's Health
Volume33
DOIs
Publication statusPublished - Jan 2022
Externally publishedYes

Keywords

  • Complete uterine prolapse
  • Pregnancy
  • Scars
  • Suture techniques
  • Vaginal delivery

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

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