Is it possible to get pregnant with prolapsed dad? Prolapse of the uterus in the early and late stages of pregnancy: why does it prolapse and is it possible to give birth? What is uterine prolapse

Nowadays, a gynecologist can diagnose uterine prolapse in many women of any age. If such a diagnosis is made, the question of pregnancy is at risk.

The whole point is that during the period of fetal development, the uterus will descend quickly. This situation will provoke many problems and also interfere with normal gestation. And although experts have a positive view of pregnancy with such a diagnosis, they still advise first solving the problem and only then planning conception.

So in what cases is it still impossible to get pregnant?

When hormonal imbalance caused uterine prolapse. In women, the ability to bear children directly depends on hormonal levels, which in such cases makes the possibility of pregnancy extremely difficult.

Another serious problem is the last stage of this pathology, when conception is impossible because the uterus has prolapsed. It is also impossible to get pregnant if the uterus is in good shape, or an inflammatory process has begun, which closes the entrance to the cervix with swelling, which also makes the process of conception impossible.

Dangers of the disease

At the very beginning of pregnancy, there is a chance of fetal death or miscarriage. The fact is that there are no optimal conditions for the development of the embryo, and the cervix is ​​under strong pressure from the organs.

Also, it is worth noting that severe cases of pregnancy failure and loss of the uterus are possible. A difficult pregnancy, together with the inflammatory process, can result in purulent inflammation of the uterine tissue. To prevent unwanted consequences, it is better to remove the uterus.

The development of the embryo may lead to prolapse of the uterus, which can have a negative impact on the pelvic organs, since a lot of pressure will be placed on them. This can cause urinary incontinence, constipation and heartburn. As pregnancy progresses, these problems will worsen.

Women in labor with this disease are under constant medical supervision from the very beginning of pregnancy, and from the beginning of the second trimester they must go into confinement. Moreover, they must maintain bed rest until the birth, because, as mentioned above, the internal organs are under great pressure and may not be able to withstand it.

If you still manage to get pregnant, the expectant mother needs to take all precautions.

To begin with, you should pay attention to the bandage. It will maintain the fetus and entrails in the correct and desired position. In addition, it will relieve tension from the spine and ensure the correct positioning of the fetus in the womb.

If the bandage and exercises do not help, then you should turn to an obstetric pessary. This is a plastic or silicone ring that is inserted into the vagina to properly support the uterus. The problem is how to place the ring correctly and not harm the baby.

In cases where uterine prolapse still remains after childbirth and drug treatment does not produce any results, surgical intervention is required. This disease is a big problem, especially after pregnancy. That is why a woman in labor must be under the constant supervision of a doctor and comply with all his requirements and recommendations.

When the uterus prolapses, it gradually moves from its normal physiological position outward through the walls of the vagina. The extreme degree of prolapse is considered to be uterine prolapse, which is a very painful condition and can only be treated surgically. Theoretically, mild uterine prolapse and pregnancy are compatible, however, women with such a pathology most often have to remain in hospital for a long time. Folk remedies that can be used during pregnancy can serve as auxiliary therapy.

Causes and manifestations of the disease

Uterine prolapse can be caused by the following factors:

• muscle injuries in the pelvic area;
• multiple natural births;
• numerous ruptures of the perineum (they are especially dangerous if the sutures are applied incorrectly);
• congenital malformations of the internal genital organs;
• neurological disorders that affect the innervation of organs in the pelvic area.

Concomitant reasons for the development of uterine prolapse are middle and old age of a woman, chronic constipation and frequent carrying of heavy objects. Complicated labor (eg, breech position, use of a vacuum) can also cause the cervix to weaken and prolapse.

Symptoms of uterine prolapse can be different - it all depends on the stage of the disease (there are 4 stages in total). At the first stage, the entire uterus or only its cervix descends, but the descended part is not visible from the vagina even with significant muscle tension. In the second stage of development of the disease, the uterus drops lower, which is why it can be seen from the vagina when a woman pushes. During the third and fourth stages, the uterus may partially or completely fall out of the vagina.

How dangerous is the disease when carrying a child?

When the uterus prolapses, it is theoretically possible to become pregnant only in the initial stages of the disease, since with its complete prolapse, as a rule, there is no question of sexual intercourse. Pregnancy also becomes impossible in situations where the uterus is too stretched or constantly inflamed.

The danger of carrying a child with this pathology is that the normal tone of the uterine muscles is disrupted and there is a high probability of premature birth or involuntary miscarriage. In the second half of pregnancy, symptoms of prolapse intensify as pressure on the pelvic organs increases due to the increase in size and weight of the uterus.

A woman may feel nagging pain in the lower abdomen, bloating and increased pressure. If you follow medical recommendations, use a bandage and folk remedies, and perform special gymnastics, pregnancy can usually be maintained. However, it is better to prevent this pathological condition before conception, since it makes the pregnancy process very difficult, and the woman often needs round-the-clock medical supervision.

Traditional treatment options

Decoctions and infusions for internal use can slightly improve the tone of the muscles of the uterus and prevent its further prolapse. Their use during pregnancy must be coordinated with a doctor, because many herbs can lead to miscarriage and other undesirable consequences. The following traditional medicines are considered safe for pregnant women:

1. Quince infusion. It normalizes the muscle tone of the uterus and rectum, so it is a good remedy not only for prolapse of the uterus, but also for hemorrhoids. To prepare it you need 2 tbsp. l. dry fruits of the plant, pour 300 ml of cold water and leave for 10 hours. Then the infusion should be brought to a boil and kept in a water bath for 10 minutes. After cooling, you need to take 100 ml three times a day.
2. Plantain decoction. 1 tbsp. l. The leaves of the plant must be poured into 1 liter of boiling water and simmered over low heat for 10 minutes. The product should be infused for 2 hours under a closed lid, after which it should be strained and a little liquid honey should be added to improve the taste. It is recommended to drink the decoction 50 ml 2 times a day between meals.
3. Melissa infusion. In addition to strengthening the muscles of the vagina and uterus, this remedy calms the nervous system and normalizes sleep. In 200 ml of boiling water you need to add 2 tbsp. l. dry lemon balm herb, leave for 30 minutes. You need to drink herbal tea in a strained glass before going to bed.

Sitz baths

With some medicinal herbs, you can carry out local water procedures that improve blood supply to the pelvic organs and restore muscle tone. The temperature of local baths during pregnancy should not exceed 38-40 °C. Ideally, the solution should be warm, but not hot. Cold water is also not suitable for this purpose, as it can cause cystitis or inflammation of the uterine appendages. Here are recipes for solutions that can be prepared at home:

1. Oak bark decoction. Add ¼ cup of vegetable raw materials to 2 liters of boiling water and cook over low heat for 30 minutes. After filtering and cooling, the solution must be mixed with boiled water. You should take a bath twice a day. The duration of the procedure is 10 minutes.
2. Infusion of yarrow. A glass of dry plant material should be filled with 3 liters of boiling water and left for 30 minutes under a closed lid. After cooling and filtering, the solution must be used for local water procedures before bed and in the morning.
3. Decoction of calendula flowers. 5 tbsp. l. dry flowers, pour 1 liter of boiling water and leave for 30 minutes. After straining, you need to mix it with warm boiled water and take a sitz bath for 15 minutes. It is advisable to do the procedure several times a day.

Gymnastics for pregnant women

If strict bed rest is not recommended for the patient, then you can discuss with your doctor the possibility of strengthening the pelvic floor muscles with simple exercises. The most important thing when doing them is to listen to your body. If during gymnastics a pregnant woman experiences pain, it becomes too difficult for her, the training should be stopped immediately. Here are some simple physical exercises:

1. Knee-elbow pose. This is one of the most common exercises recommended for pregnant women. It not only improves the tone and blood supply of the uterus, but also helps prevent cramps in the calf muscles. This pose also helps the child take the correct position (upside down). To correctly take the knee-elbow position, you need to get on all fours and transfer your body weight to your hands, shifting the center of gravity forward.
2. Kegel exercises. Pregnant women are recommended to rhythmically squeeze and relax the intimate muscles of the vagina for 5 seconds. The total duration of Kegel exercises should be 15 minutes per day.
3. Prolonged contractions of intimate muscles. The meaning of the exercise is the same as with Kegel gymnastics, but you need to relax and tense your muscles not for 5, but for 15-20 seconds. In total, such contractions should be performed for 10-20 minutes per day.
4. Bike. Lying on your stomach, you need to smoothly make rhythmic movements with your legs, imitating riding a bicycle. The duration of such gymnastics is usually about 10 minutes.
5. Raising the pelvis. Lying on your back, you need to raise and lower your pelvis for 5 minutes. At this time, your knees need to be bent and your abdominal muscles should be tense.

Prevention

Uterine prolapse is one of the diseases that is much easier to prevent than to treat. Considering the consequences of the disease, its prevention should be carried out from a young age, that is, long before childbirth. Girls need to engage in light sports and strengthen their abdominal muscles. Kegel exercises (relaxation and tension of intimate muscles) are considered useful. They not only help keep the uterus in good shape, but also reduce the likelihood of ruptures during childbirth.

Other ways to prevent uterine prolapse include:

• adequate management of the birth process;
• compliance with the protective regime after childbirth;
• timely treatment of all inflammatory processes in the pelvic organs;
• performing exercises for correct posture;
• moderate constant physical activity.

Women are not recommended to lift weights weighing more than 10 kg, as this significantly affects the stretching of the muscles in the pelvic area and can cause a weakening of their normal tone. It is important to monitor your diet - the body must receive a sufficient amount of vitamins and minerals. Particular attention should be paid to preventive measures in the first year after childbirth, during menopause and in case of hormonal disorders.

Dear Olga!

You correctly noted that when planning a pregnancy in women with uterine prolapse, the difficulty arises not with conception, but with bearing a child. This pathology provokes certain risks that can be fatal to the fetus and pose a threat to the health of the expectant mother. Unfortunately, there is no single forecast for whether you will be able to safely bear a child, but you cannot categorically state that the birth of a second child in your family cannot take place. It all depends on the severity of the pathology and the degree of sensation of the uterus.

Pregnancy and uterine prolapse

When planning a pregnancy with your pathology, you should be warned about all possible risks and consequences. However, most often doctors do not consider uterine prolapse a complete contraindication to pregnancy. However, you should understand that pregnancy can end in miscarriage or miscarriage, especially in the early stages.

The reason for this is the lack of normal conditions for the development of the baby, because when the uterus prolapses, inflammatory processes often develop that prevent the normal development of pregnancy. In addition, the walls of the organ are deformed, and as the fetus grows, the uterus will descend very quickly, which can lead to pregnancy failure and even the need for complete removal of the organ. The growth of the uterus increases pressure on surrounding organs - the intestines, bladder, etc., which can lead to urinary incontinence, severe constipation and other unpleasant conditions. When deciding to become pregnant when the uterus has prolapsed, a woman should be prepared that she may have to lie in bed for most of the pregnancy. However, it must be emphasized once again that the prognosis depends entirely on the degree of prolapse and the severity of the pathology established by specialists.

There are several stages of uterine prolapse:

• First stage: upon examination it is discovered that the external os of the cervix is ​​lowered relative to the normal position, the woman feels discomfort.
• Second stage: the cervix falls out of the vagina, sexual activity becomes impossible.
• Third stage: the entire uterus falls out of the genital slit, and the functioning of a number of organs is disrupted. The prolapsed uterus becomes inflamed, erosions appear, and an abscess may develop.

Treatment of uterine prolapse

Treatment for uterine prolapse should begin long before the expected pregnancy. The initial stage of the pathology, with adequate treatment, makes it possible to bear a child under the supervision of doctors. At the first stage, conservative treatment is prescribed, including general strengthening therapy aimed at improving the tone of the abdominal wall and ligaments. This includes physical therapy and water procedures. It is necessary to perform a special set of exercises to strengthen the gluteal muscles, elements of oriental dancing, Kegel exercises, etc. Sometimes such work on your body gives very good results, but if pregnancy occurs, in any case you will need to constantly wear bandages.

If the prolapse has reached the second and third stages, surgical treatment is prescribed. So, it is possible to surgically install a pessary, which will prevent prolapse of the uterus from the vagina. This device is able to keep the uterus at the desired level throughout the entire period of pregnancy, however, this method has its drawbacks. So that it does not harm the fetus, it must be skillfully and correctly installed. In addition, when worn for a long time, it leads to the appearance of bedsores and stretching of the pelvic muscles, so when installing a pessary, a woman should be under constant medical supervision and douche every day.

In advanced stages, the uterus is sutured to the base of the muscles. This operation is quite effective, but has a long rehabilitation period, which excludes heavy lifting and any physical activity.

Best regards, Ksenia.

Pregnancy with uterine prolapse may have additional complications. Previously, this pathology often led to infertility. Thanks to modern treatment methods, every patient with a similar disease has the opportunity to bear and give birth to a full-fledged baby, without harming her own condition.

Features of conception

Uterine prolapse often leads to the development of hormonal disorders. They are the ones who most often become an obstacle to conceiving a child. In case of this type of violation, it is recommended to do the following:

1. Contact a gynecologist.
2. Complete their prescribed examination.
3. Take several courses of hormone therapy.
4. Strengthen the perineal muscles with special exercises (the most popular is the Kegel complex).

The most serious problem for pregnancy is the complete descent of the cervix into the vagina.

This makes conception impossible until special treatment is carried out. One of the effective methods is the installation of a gynecological pessary. It is a special ring that supports the uterus in its normal position. A woman will also not be able to get pregnant if the uterus becomes inflamed after prolapse. Conception in such situations becomes possible only after treatment.

Course of pregnancy

If pregnancy occurs during uterine prolapse, it is often accompanied by some problems that healthy women encounter much less frequently. One of the most common problems is increased pressure on the uterus. A pregnant woman with a uterus that is too low develops the following symptoms:

• pain in the lower abdomen;
• urinary incontinence;
• frequent constipation.

It is worth noting that all these symptoms often overtake a healthy woman. Unfortunately, in those expectant mothers who are diagnosed with uterine prolapse during pregnancy, all these unpleasant manifestations are several times more pronounced. In this case, the clinical picture increases with the growth of the fetus and increased pressure on the walls of the uterus.

Uterine prolapse and pregnancy are not the safest combination for the fetus. The fact is that its development in this pathological condition is under threat due to a significantly increased likelihood of miscarriage, premature birth and pregnancy loss. The installation of a gynecological pessary provides a relatively good effect for the prevention of this type of complications. Unfortunately, its use has its drawbacks:

1. Bedsores may form.
2. A patient with a gynecological pessary installed has to visit a gynecologist weekly.
3. It is necessary to douche with chamomile decoction every day.
4. The maximum period of wearing a gynecological pessary is limited to only 4 weeks.

In this case, installation of a pessary is possible only for those patients whose uterus is slightly prolapsed. In more serious cases, this device is useless.

Another possible extremely negative consequence of pregnancy in combination with uterine prolapse is the likelihood of the formation of severe inflammatory processes. In some cases, they become so severe that a hysterectomy has to be performed. Most often this happens when an abscess develops in the uterus due to inflammation. Surgery is performed to save the mother's life. Naturally, the removal of the organ in which the child is born is accompanied by termination of pregnancy.

In addition, uterine prolapse during pregnancy implies a more frequent stay for the patient in a hospital setting. Also, such expectant mothers have to spend a significant part of their time in a lying position, because it is in this position that the lowest possible pressure is placed on the pregnant belly.

How to avoid complications?

Many women with a similar pathology wonder whether it is possible to become pregnant with uterine prolapse and not encounter serious complications. Modern medicine really allows us to avoid most of the negative consequences. To do this, the patient will have to:

1. Consult a gynecologist.
2. Strengthen the muscles of the perineum.
3. Complete the prescribed course of treatment.

Consulting a doctor will help you choose the right direction in preparing the body. He will examine the patient, tell you how to get pregnant with this disease and not encounter the most dangerous complications of uterine prolapse. The gynecologist will prescribe the necessary examination. Their minimum volume will include the following activities.

• general blood analysis;
• general urine analysis;
• blood test for glucose levels;
• blood chemistry;
• blood test for the content of female sex hormones;
• Ultrasound examination of the pelvic organs.

After this examination, the doctor will determine the degree of uterine prolapse. If this pathology is not very pronounced, then the specialist will tell you about exercises to strengthen the muscles of the perineum. The most commonly used is the Kegel complex. It allows you to almost completely restore the position of the uterus within a few months. Unfortunately, such exercises are effective only in mild cases of the disease.

In order to ensure the normal position of the body and cervix during pregnancy, women with severe prolapse of these organs undergo surgery. It involves fixation of the uterus to surrounding tissues. Thus, a possible miscarriage or termination of pregnancy becomes much less likely outcomes after conceiving a child.

With any prolapse of the uterus, various types of inflammatory and infectious processes pose a significantly greater danger to pregnancy. Therefore, it is important to carry out specific treatment for this pathology even before the baby is conceived. Otherwise, not only may a miscarriage or termination of pregnancy occur, but there may also be a need for a complex surgical intervention - a hysterectomy. After such treatment, a woman will no longer be able to become pregnant.

Among other things, the doctor may well prescribe replacement therapy to a woman in cases where prolapse of the uterine organ leads to a decrease in the production of female sex hormones.

All recommendations of specialists for this pathology must be followed. If you do exactly as gynecologists advise, then the likelihood of having a healthy baby will significantly increase, and the risk of developing serious complications will sharply decrease.

Prolapse of the cervix or uterus during pregnancy is just a special case from a large group of conditions associated with the fullness of the pelvic floor in women. Correctly, the group of these diseases is called “prolapse or prolapse of the female genital organs” or “gastrointestinal tract prolapse.”

Such diseases are typical for women aged 40+, but there are unpleasant exceptions in young patients, including during pregnancy. All statistics on this disease refer to women over 40 and, according to experts, account for about 35% of women.

You can imagine that every third woman after forty years has one or another version of this problem, which disrupts the quality of life, causing physical and psychological suffering.

Degree of uterine prolapse. Source: borninvitro.ru

In a large group of pelvic organ prolapse, several subgroups can be divided into:

Prolapse of the vaginal walls. This is the most common and common situation. Of the variants of “prolapse,” prolapse of the vaginal walls is the mildest degree. Both the front and back walls of the vagina can descend, as well as both walls at the same time.

There are three degrees of prolapse in total, from the first - the most insignificant, to the third - the most pronounced. It is generally accepted that prolapse of the anterior vaginal wall is always associated with a violation of the normal anatomical position of the bladder and is called cystocele.

When the posterior wall prolapses, the rectum and its function are affected and such prolapse is called rectocele. Prolapse of the vaginal walls is by far the most common situation faced by pregnant women, as well as patients after childbirth.

Incomplete uterine prolapse is a kind of boundary between prolapse of the vaginal walls of the third degree and complete prolapse of the uterus. As a rule, with this option, the cervix is ​​already visible from the genital slit, especially after a long stay in an upright position or physical activity, but the body of the uterus is still “hiding” in the pelvis. Patients suffer greatly not only due to cosmetic defects, but also due to dysfunction of the bladder and rectum.

Complete uterine prolapse is an extreme version of prolapse, when not only the cervix is ​​visible from the genital slit, but also the body of the uterus itself, enclosed in the walls of the vagina. A “prolapsed” uterus can no longer adjust itself; women experience enormous difficulties with urination and defecation.

It is important to understand that uterine prolapse during pregnancy is an almost casuistic and unlikely situation, since the ligamentous apparatus of the growing uterus with the fetus, on the contrary, “pulls” the uterus up, and the expanding uterus is pushed into the small pelvis, so the pregnant uterus simply cannot “fall out.”

There are examples when, during pregnancy, incomplete uterine prolapse or cervical elongation even improved their course, unfortunately, significantly worsening immediately after childbirth.

Elongation of the cervix is ​​a type of prolapse of the uterine cervix, in which, due to the peculiarities of the redistribution of the load on the pelvic ligaments, the main load falls on the ligamentous apparatus of the cervix, as a result of which it gradually lengthens in size, changes its configuration and begins to appear from the genital slit.

This form differs from incomplete prolapse in that the uterus itself, in the case of pure cervical elongation, does not change its anatomical position. This form of prolapse also occurs in young women and pregnant women.

Of course, over time, easier forms can turn into more complex and neglected ones. This can happen over a long period of time and gradually - over decades, or it can happen in one moment - especially with a sharp cough, sneezing, severe constipation or jerky lifting of weight.

Causes

There are many reasons for pelvic organ prolapse, but the basis is a certain genetic defect of connective tissue, in which there is a violation of the synthesis of collagen and other connective tissue fibers.

As a result, connective tissue throughout the body, including the pelvic floor, which consists of muscles and fascia, has reduced tolerance or resistance to physical stress. This feature is called systemic connective tissue dysplasia syndrome.

Childbirth. Unfortunately, this absolutely physiological process in patients with a tendency to prolapse can provoke its appearance, and even at a young age. The number of births, the weight of the fetus, and the characteristics of the course of labor are of great importance. The more births there were, the larger the children, the higher the chances of a violation of the anatomy of the pelvic floor. Tears and cuts in the perineum are another plus with this unpleasant piggy bank.

Heavy physical labor, namely work associated with lifting weights. When lifting a large weight, there is a sharp increase in intra-abdominal pressure, which seems to “push” the pelvic organs down towards the vagina.

Operations on the pelvic floor are relevant in this case, not only obstetric operations for cutting and suturing the perineum (episiotomy, perineotomy), but also, say, other interventions in this area. For example, operations on the rectum, operations to eliminate fistulous tracts, coccygeal tracts, and so on.

Severe constipation - the problem of constipation, as well as lifting heavy objects, is associated with an increase in intra-abdominal pressure when straining.

Severe atrophic changes in the vagina - such changes in the elasticity of the vaginal walls are often observed in menopausal patients and are associated with a deficiency of sex hormones. Less commonly, there are atrophic changes after chemotherapy or radiation therapy for cancer, against the background of autoimmune diseases, for example, Sjögren's syndrome.

However, whatever the provoking factors, the connective tissue defect will always come first. This is why we often see patients who have given birth to three or four children, weighing about 4 kg, who have worked as sleeper workers all their lives, but with an absolutely perfect pelvic floor. In contrast, a patient who gave birth to one small child without a perineal injury and who worked as an accountant all her life may have complete uterine prolapse.

Symptoms of prolapse

The clinical manifestations and symptoms of uterine prolapse during pregnancy are in principle similar to those outside pregnancy.

Visual and tactile sensation of “discomfort” or “disorder” in the genital area. Patients often compare the “prolapsed” vaginal wall to an egg or a ball; some mistake a rectocele for a large hemorrhoid.

Discomfort when urinating or defecating, more pronounced the higher the degree of prolapse of the vaginal walls or prolapse of the uterus. With complete prolapse, patients cannot urinate or have a bowel movement until the uterus is manually pushed back into the vagina. In addition, patients are worried about frequent urge to go to the toilet, unproductive urination and defecation, a large amount of residual urine in the bladder, and urine leakage.

Defects, cracks and ulcers on the “prolapsed” mucous membranes, cervix. The appearance of a so-called decubital ulcer on the cervix during its elongation or complete prolapse of the uterine cervix is ​​very typical. These ulcers arise due to the fact that the delicate mucous membranes of the vagina and cervix are in an environment alien to them, are easily injured, dry out, and long-term non-healing, bleeding defects - ulcers - appear.

It is quite difficult to meet a pregnant woman with such extreme manifestations of GPO prolapse; as a rule, in young reproductively active women the situation is limited to cervical elongation or prolapse of the vaginal walls. As we have already mentioned, pregnancy is characterized by some improvement in the process.

Prolapse of the uterus during early pregnancy is most often associated with disturbances in urination and defecation, discomfort in the external genitalia, and a more frequent occurrence of secondary infection on the prolapsed vaginal walls than in a pregnant woman with normal anatomy. In later stages, as the growing uterus “pushes” upward, the situation may even improve on its own.

Treatment and prevention

Outside of pregnancy, the treatment of choice for severe prolapse is surgical treatment of prolapse - one or another version of pelvic floor plastic surgery. Modern gynecology has a lot of options for such operations, depending on the age of the patient, her main complaints and wishes, as well as the financial interest of the woman herself:

Pelvic floor plastic surgery with mesh prostheses. There are special types of grafts that are inserted in a special way between the muscle layers and fascia of the pelvic floor and strengthen the sagging and overstretched pelvic floor. This is a modern and high-tech type of operation, but it is the one that requires the main material injections from the patient herself. Mesh prostheses are quite expensive and are purchased by the patient independently.

Vaginal plastic surgery using one’s own tissues is an older method that has been proven for decades, including cutting out flaps from the vaginal walls, suturing them, shortening the ligamentous apparatus, and so on.

Hysterectomy is almost always performed in patients 40+ with complete uterine prolapse. Removal options can be either abdominal surgery through an incision in the anterior abdominal wall, or a new modern method of vaginal hysterectomy through the anterior vaginal fornix. Removal of the uterus is always combined with pelvic floor plastic surgery using one’s own tissue or a prosthesis.

The Manchester operation is an old but proven method for cervical elongation - shortening the length of the cervix, plasticizing the cervix and strengthening the cervix and dome of the vagina with a ligamentous apparatus from the cervix itself.

These are surgical treatment methods, which, of course, are not performed on a pregnant woman. What to do with uterine prolapse during early pregnancy? Of course, the management of such patients is strictly conservative.

Kegel exercises and various vaginal exercises based on it. This gymnastics was specially developed by gynecologist Hegel or Kegel for the treatment of early degrees of prolapse of the gallbladder or the prevention of further progression of the process.

The point of the exercises is to compress and relax the muscles of the vagina, perineum and sphincters of the bladder and rectum - the muscles become toned, strengthened and keep the pelvic floor in good shape.

Patients are sometimes very skeptical about “physical education”, but with small degrees of prolapse of the vaginal walls, with regular daily implementation of the complex, the results are amazing.

Technological progress has created special simulators based on these exercises, which are inserted into the vagina and even attached to programs on a tablet or phone. The program suggests sets of exercises, controls the pressure on the machine and reminds you of the start time of the set of exercises.

Introduction of uterine pessaries and rings with pronounced elongation or prolapse of the walls. These are special products made of silicone or medical plastic that are inserted into the vagina or placed on the cervix, holding the vaginal walls and pelvic organs inside. There are many models of such pessaries; a specific model and size can only be recommended by a gynecologist for each specific patient.

Prevention of large fetuses, polyhydramnios, traumatic births, careful suturing of the perineum and vaginal ruptures.