What Are the Concerns of Prolapse in Pregnancy?

Prolapse of internal organs in pregnancy might be a cause for emergency medical treatment, depending on the organ that slips from its normal position. A bladder prolapse in pregnancy usually occurs without complications, but a uterine or umbilical cord prolapse might require emergency surgery. Pregnancy is one of the causes of organ prolapse, along with aging, obesity, and loss of estrogen from menopause or a hysterectomy.

Obstetricians commonly monitor a uterine prolapse during pregnancy to observe its severity. They might prescribe a pessary device to hold the uterus in its normal position while the pregnancy progresses. A pessary refers to a round device commonly constructed of silicone inserted into the vagina. It provides support to weak muscles that permit the uterus to descend into the vaginal canal.

Women who suffer a bladder prolapse in pregnancy might need a caesarean birth to avoid aggravating the condition. This occurs when the wall between the bladder and vagina becomes stretched and weak, allowing part or the entire bladder to slip into the canal. The urethra, the tube that carries urine from the bladder for disposal, might also slip into the vagina. Ligaments that become stretched during pregnancy and childbirth represent the most common cause of bladder prolapse.

Umbilical cord prolapse might require emergency surgery if oxygen to the baby is impeded. Cord prolapse in pregnancy might occur before the baby’s head engages in the birth canal, usually in the later stages of pregnancy. This condition cannot be prevented, and doctors typically perform caesarean surgery to safely remove the baby.

Prolapse of the umbilical cord is more common if an infant is positioned sideways in the womb instead of in the head-down position. It also occurs more often in women who have given birth to twins and triplets. Experts believe too much fluid in the uterus, or when the water breaks too soon, might lead to umbilical cord prolapse in pregnancy. They advise women who see or feel the umbilical cord in the vagina to seek medical attention.

Symptoms of a prolapsed organ include a feeling of fullness or that something is falling out of the vagina. This sensation might become uncomfortable, especially if a woman has been standing most of the day. Feeling a bulge in the vaginal canal and incontinence are additional signs of a prolapsed internal organ. Some women lose urine when they cough or sneeze, urinate frequently, or cannot fully empty the bladder.
In addition to weakened muscles caused by pregnancy, constipation also contributes to organ prolapse. Women who suffer from disorders of the connective tissue, such as lupus or rheumatoid arthritis, also face a higher risk of these conditions. Pelvic floor exercises help some women strengthen the ligaments and muscles that hold pelvic organs in place. Called Kegel exercises, they consist of contracting and releasing the muscles that hold urine.