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Writer's pictureDr. Girija Wagh

Prolapse During Pregnancy: Causes, Symptoms, and Management



Prolapse during pregnancy is a condition that might not be widely discussed but is important to understand. As a pregnant woman's body undergoes incredible changes, certain physical adjustments and adaptations are necessary to support the developing baby. Occasionally, these changes can weaken the muscles and tissues that hold the pelvic organs in place, leading to a condition known as prolapse.


In this article, we’ll explore what prolapse is, its types, symptoms, causes, and how to manage it during pregnancy.


What is Prolapse?


Prolapse occurs when pelvic organs like the uterus, bladder, or rectum descend from their usual position and bulge into or press against the vaginal wall. This happens due to a weakening of the pelvic floor muscles and surrounding tissues, which support these organs. Pregnancy can sometimes put extra pressure on these muscles, leading to a prolapse.


Types of Prolapse


There are different types of prolapse that can occur during pregnancy, each affecting specific organs:


  1. Uterine Prolapse: The uterus slips down into the vaginal canal.

  2. Bladder Prolapse (Cystocele): The bladder descends and pushes against the vaginal wall.

  3. Rectal Prolapse (Rectocele): The rectum moves downward and bulges into the vagina.

  4. Vaginal Vault Prolapse: Typically occurs in women who’ve had a hysterectomy, where the top of the vagina drops down.


Causes of Prolapse During Pregnancy


The pelvic region naturally experiences extra pressure during pregnancy due to a combination of factors, including:


  • Increased Weight and Pressure: As the baby grows, the weight and pressure on the pelvic region increase, putting strain on the pelvic floor.

  • Hormonal Changes: Hormones like relaxin, which increase during pregnancy, loosen muscles and ligaments to prepare the body for childbirth. While necessary, these hormonal changes can also weaken the pelvic floor.

  • Multiple Pregnancies and Childbirth: Women, who have had multiple pregnancies, especially if they involved difficult or prolonged labour, are at a higher risk of prolapse.

  • Genetic Factors: Some women may be genetically predisposed to weaker pelvic floor muscles, increasing their risk.


Symptoms of Prolapse


Prolapse can vary from mild to more severe, and symptoms often depend on the extent and type of prolapse. Common signs include:


  • A feeling of heaviness or pressure in the pelvic area

  • A noticeable bulge in or near the vaginal opening

  • Discomfort when urinating or difficulty emptying the bladder

  • Constipation or challenges with bowel movements

  • Lower back pain


Managing Prolapse During Pregnancy


While prolapse might seem concerning, there are ways to manage symptoms and prevent it from worsening. Here are some tips and recommendations to help alleviate discomfort and support pelvic health:


  1. Pelvic Floor Exercises (Kegels): Strengthening the pelvic floor muscles is crucial. Kegel exercises are simple, can be done at any time, and help reinforce the pelvic muscles that hold the organs in place.

    • How to Do Kegels: Tighten the muscles you would use to stop urination, hold for a few seconds, and then release. Repeat several times a day for the best results.

  2. Avoid Heavy Lifting: Lifting heavy objects can put additional strain on the pelvic floor, so try to avoid any strenuous lifting. If lifting is necessary, make sure to use proper techniques by bending the knees and engaging the core muscles.

  3. Practice Good Posture: Standing and sitting in a posture that evenly distributes weight across the body can reduce stress on the pelvic area. Avoid slouching, and consider using a pregnancy support belt if needed.

  4. Physical Therapy: Specialized pelvic floor physical therapy can help with managing prolapse symptoms. A trained therapist can guide you through exercises and techniques to improve muscle strength and alleviate pressure on the pelvic organs.

  5. Stay Hydrated and Eat Fibre-Rich Foods: Constipation can aggravate prolapse, so maintaining a diet rich in fibre and staying hydrated is essential. This will help keep bowel movements regular and reduce straining.

  6. Listen to Your Body: If you feel any heaviness or discomfort, take breaks and rest. Allowing yourself time to lie down or sit with your feet elevated can relieve some of the pressure on the pelvic floor.


What to Expect After Pregnancy


In many cases, prolapse symptoms improve after delivery. However, the recovery of the pelvic floor muscles depends on several factors, including the type of delivery, overall pelvic strength, and postpartum recovery practices. Regular pelvic floor exercises after childbirth can aid in regaining muscle strength and reducing prolapse symptoms. For severe cases, consulting a healthcare provider for further treatment options, such as physical therapy or even surgery, may be necessary.


When to Seek Medical Advice


It’s always best to talk to a healthcare provider if you suspect any signs of prolapse during pregnancy. Severe symptoms, such as a large bulge, significant discomfort, or issues with bladder and bowel control, should be promptly addressed. A doctor can provide a proper diagnosis and recommend the best course of action based on the severity of the condition.


Ending Words


Prolapse during pregnancy can feel unsettling, but understanding the causes, symptoms, and management options can help reduce anxiety and discomfort. Simple steps like pelvic floor exercises, avoiding heavy lifting, and being mindful of posture can help maintain pelvic strength and support. Prolapse doesn’t have to disrupt your pregnancy journey—with the right knowledge and guidance, you can continue to enjoy a healthy, confident pregnancy.


For any concerns, don’t hesitate to consult your healthcare provider—they’re there to support you every step of the way.

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