Causes of spontaneous inversion of the uterus after childbirth24.05.2022
Eversion of the uterus after childbirth occurs in every second patient over the age of 50 years. The provoking factor is hormonal restructuring and weakening of the ligamentous apparatus of the pelvic floor. However, the true causes of the pathology are in the distant past, and complicated childbirth is considered one of them.
What it is
Cervical prolapse is a common gynecological pathology that usually occurs in women after natural delivery. This condition is characterized by the displacement of the walls of the vagina, the cavity of the cervical canal and the uterus from the usual anatomical location. At the initial stages, the pathology is asymptomatic. Remaining unnoticed, the disease progresses over the years and acquires characteristic features.
Eversion of the uterus after childbirth occurs as a result of trauma to the muscles of the pelvic floor
In gynecology, there are three stages of prolapse:
- spontaneous displacement of internal organs from their usual places, provided that the neck is located inside the vagina;
- exit of the vaginal part of the cervical canal beyond the genital gap during physical exertion or normal straining;
- complete inversion of the uterus after childbirth, in which the cervix is located outside the small pelvis, even in a relaxed state.
Many women do not admit that they may have a similar problem. The disease is positioned as an age-related disease, but it acquires its beginnings in youth. Therefore, it is important for all girls and women to prevent uterine prolapse.
Causes of pathology
The main cause of the pathology is considered to be severe prolonged labor. During this process, the load on the pelvic floor muscles increases. At the birth of a large child or a multiple pregnancy, microtears appear on the ligaments, which in the future contribute to the loss of elasticity. Also, the cause of prolapse is rough and improper management of natural childbirth. The use of forceps, vacuum, and incisions increase the risk of uterine prolapse in the future. Spontaneous tissue rupture also increases the likelihood of pathology.
Another cause of prolapse is dystrophic changes in the ligamentous apparatus. They can be caused by various diseases, injuries, surgical interventions.
The provoking factor is a prolonged cough, constipation, hard physical labor and a decrease in the production of estrogen in the body. During menopause in women, the progression of pathology accelerates, as the ovaries lose their function and stop producing hormones.
Clinical manifestations of uterine inversion after childbirth
At the initial stage, there may be no symptoms. Over time, a woman begins to feel such signs:
- stomach ache;
- sensation of the presence of a foreign object in the vagina;
- bleeding from the genital tract;
- frequent inflammatory diseases of the urogenital area;
- background diseases of the cervix;
- urinary incontinence;
- discomfort during intercourse.
The higher the stage of descent, the brighter the clinical picture will be. In many patients, the first symptoms are involuntary urination and pain during sexual intercourse.
Consequences for a woman
The main consequence for the patient when the uterus is lowered is physical and aesthetic discomfort. With urinary and fecal incontinence, desocialization develops, psychological complexes appear. With prolapse, intimacy becomes impossible, which provokes misunderstanding with a partner.
In the later stages, the disease leads to atrophic changes in the tissues. Due to the location of the internal organs behind the genital slit, inflammatory processes often recur, ulcers form on the mucosa, and tissue bleeding increases. Pathology leads to vascular disorders, the appearance of varicose veins in the pelvis, displacement of internal organs.
Depending on the initial situation and the age of the patient, an individual method of treatment is selected. In young women with stage 2-3 eversion, surgery is recommended. During the operation, suturing of internal organs or prosthetics of the ligamentous apparatus is performed. At the first degree, physiotherapy, gymnastics and wearing a pessary can give a good result.
Surgery is also recommended for elderly patients with prolapse, however, for some, surgery is contraindicated for health reasons. In this case, a palliative method of correction is chosen. A woman is assigned to wear a pessary for life, which can be supplemented with hormonal, analgesic and anti-inflammatory drugs.
Inversion of the uterus after childbirth is a dangerous condition that can be prevented. For prevention, it is necessary to choose a rational approach to the management of pregnancy and delivery. After childbirth, restorative gymnastics is recommended, which allows you to increase the elasticity of the ligaments of the pelvis.
See also: sideburns for girls