WILL UTERINE PROLAPSE AFFECT MY PREGNANCY?
Prolapse of the uterus occurs when the ligaments and tendons that hold the uterus in place within the pelvic cavity become weak. As the tension in the support structures decreases, the uterus may flop forwards or backwards, or begin to protrude through the vagina. It is most common for a woman to suffer from a prolapsed uterus after she has given birth to one or more babies. Given the amazing expansion of the uterus and the reshuffling of internal organs that occurs to accommodate the developing baby, it is little wonder that after the baby is born, ligaments and tendons become somewhat stretched! Your options for repairing the prolapsed uterus will depend on whether you wish to have more babies.
If you wish to have more children, your surgeon will assist you in whatever practical way he can. It is often possible to “resuspend” the uterus by surgically shortening the pelvic ligaments and tendons, or by supporting the uterus with a synthetic mesh sling. Subsequent pregnancies and deliveries may cause the uterus to prolapse again and further surgery to repair the damage or remove the uterus will be necessary.
Removal of the uterus, known as hysterectomy, may be the first port of call for repair of a prolapsed uterus after pregnancy. Since the uterus is necessary to become pregnant, your surgeon will perform a hysterectomy only if you have finished your family or if there are no other options available for you.
Sometimes, a woman’s uterus may be tilted forwards or backwards within the pelvic cavity, rather than being prolapsed. This condition is known as “tipped uterus” and occurs for similar reasons as uterine prolapse – the uterine support ligaments are not as taut as they should be. Often, a tipped uterus occurs before a woman has had any children.
Having a tipped uterus is not usually associated with infertility and does not usually threaten an otherwise viable pregnancy. Investigating whether or not the uterus is tipped forwards or backwards is usually only considered after all other causes of female infertility have been ruled out. In rare instances only, your doctor may recommend repositioning of your uterus to enhance your chances of falling pregnant.
If your uterus is tipped and you fall pregnant, there is usually little risk to the developing baby. As your baby grows, the uterus tends to reposition itself. For most women, the uterus has righted itself by the tenth or twelfth week of pregnancy right. In exceptionally rare cases, the uterus does not move into the upright position and a miscarriage may occur. If you miscarry for this reason, your doctor may discuss with you the option of surgically correcting the position of the uterus before you try to conceive again.