GENITAL PROLAPSE IN PREGNANCY

Pregnancy is not uncommon in first-degree uterine prolapse with cystocele and rectocele. Pregnancy is, however, unlikely when the cervix remains outside the introitus and continuation of pregnancy in third degree prolapse is an extremely rare event. The incidence of prolapse is about 1 in 250 pregnancies.

EFFECTS ON PROLAPSE: There is aggravation of the morbid anatomical changes in prolapse such as marked hypertrophy and edema of the cervix, first degree becomes second degree, cystocele and rectocele become pronounced and there is aggravation of stress incontinence. These are marked during early pregnancy and the effects are due to the weight of the uterus and increased vascularity. Vaginal discharge may be copious and decubitus ulcer may develop when the cervix remains outside the introitus. There is chance of incarceration, if the uterus fails to rise above the pelvis by 16th week of pregnancy.

EFFECTS: -

On pregnancy: There is an increased chance of:

1) Miscarriage

2) Discomfort due to increased ailments

3) Premature rupture of the membranes

4) Chorioamnionitis.

During labor: There is an increased chance of:

1) Early rupture of the membranes

2) Cervical dystocia

3) Prolonged labor due to non-dilatation of cervix and obstruction due to sagging cystocele and rectocele

4) Operative interference.

During puerperium:

1) Subinvolution.

2) Uterine sepsis.

HOMOEOPATHIC MEDICINES FOR MANAGING GENITAL PROLAPSE DURING PREGNANCY: -

1) Sepia: - Indicated when there is a constant bearing down sensation in the pelvic region, that is feeling the sensation as if the uterus is dragging in the downward direction and is about to come out. Crossing the lower limbs may prove slightly helpful to decrease the bearing down sensation. This medicine yields excellent results in women at a menopausal age where the womb is in a relaxed condition with weak muscle support.

2) Lilium tigrinum:- This remedy is very beneficial in women suffering from Uterine Prolapse who have constant urge to pass urine or stool. They feel a dragging sensation in the Pelvis. Supporting the vulva or taking rest brings about a slight relief in the dragging sensation.

3) Murex: - It is of great help where the uterus is bulky, enlarged and is pushed out of the pelvis. Women experience a bearing down feeling in the pelvis and need to tightly cross legs to prevent the bearing down sensation.

4) Lappa Arcticuma:- Can be used in all those where the muscles, ligaments, and tissues in pelvis lack tonicity and are relaxed to a greater extent, resulting in a displaced or prolapsed womb.

5) Fraxinus Americana: - Used for uterine Prolapse with tumour. Fraxinus can be used when tumors like fibroid uterus are associated with Uterine Prolapse. The uterus is enlarged. Bearing down pains in the pelvis are always present