3rd degree genital prolapse in the first trimester of pregnancy is managed by :
TREATMENT DURING PREGNANCY: The symptoms are mostly pronounced in early pregnancy. * If the cervix is outside the introitus -- The cervix is to be replaced inside the vagina and is kept in position by a ring pessary. The pessary is to be kept until 18-20th week of pregnancy when the body of the uterus will be sufficiently enlarged to sit on the brim of the pelvis. The pelvic floor is too much lax -- The patient is to lie in bed with the foot end raised by about 20 cm. To relieve edema and congestion of the prolapsed mass, it should be covered by gauze soaked with glycerine and acriflavine. The treatment is continued until 18-20th week of pregnancy till the prolapsed mass is reduced in size and replaced inside the vagina. Thereafter, the patient is allowed to walk about. * If reposition is not possible and there is incarceration, termination of pregnancy may be indicated. * If the cervix remains outside the introitus even in the later months, it is preferable to admit the patient at 36th week. Reference: Dutta's Textbook of Obstetrics 7th edition page no 313
Ring pessary
Fothergill's repair
Le fo's repair
Right transvaginal sacrospinous colpopexy
Medical, surgical and gynaecological illness complicating pregnancy