BACKGROUND: Pelvic organ prolapse (POP) generally does not contribute to mortality but can worsen the quality of life, because it can cause abnormal bladder, gastrointestinal system, and sexual function disorders which indirectly cause psychosocial stress and emotional disorders such as depression, isolation, and anxiety. The main purpose of surgical action in young women with POP is to reduce complaints such as fecal and urinary incontinence and also sexual disorders, restore normal anatomy structures, prevent recurrence POP, and maintain the ability of pregnancy, labor, and normal menstrual function. Purandare hysteropexy surgery is one of the conservative surgical procedures for POP in productive women with few operative complication, shorter operating time, and minimal bleeding. At present, there is no literature of pregnant women with the mode of delivery that is effective in patients with history of purandare hysteropexy surgery. This case aims to report delivery in patient with a history of purandare hysteropexy surgery. Pregnancy can be maintained up to gestational term age, healthy baby, and no adhesion during surgery.
CASE REPORT: A 29-year-old woman in full-term gestational age of her second pregnancy with a history of purandare hysteropexy surgery 1 year ago. During antenatal care patient, an evaluation of fascia sheath with ultrasonography was performed. The method of delivery was through cesarean section. During surgery, there was no intra-abdominal adhesion, the fascia sheath is well-maintained, and lower segment of uterine is covered by anterior fascia sheath. The operation outcome was a healthy baby boy, weighted 2900 g, body length 49 cm with good Apgar score.
CONCLUSION: Purandare hysteropexy surgery is one of the conservative surgical management for conservative treatment of uterovaginal prolapse in women of reproductive age group who wish to retain their capacity for childbearing. Pregnancy up to term gestational age, during cesarean section, surgery seen no intra-abdominal adhesion, all sides of fascia sheath are well-maintained and the outcome was a baby with healthy condition.
Difficulty in predicting intra-abdominal adhesion before cesarean section: A case report
