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Gynaecology & Obstetrics Urinary Fistulas 0a5af758

Fourteen weeks pregnancy with third degree prolapse. Best management will be:

A
Sling surgery
B
Foot end elevation
C
Ring pessary
D
No treatment
High-Yield Explanation
Ans. is c, i.e. Ring pessaryRef: Dutta Obs 6th/ed, p312-3; Shaw 15th/ed, p337-8; Williams Gynae lst/ed, p545-7 (for details of pessaries)3deg prolapse with pregnancyIn early months of pregnancyIn late months of pregnancyUp till 18 weeks as after that spontaneous correction occur because uterus becomes a pelvic organAdmit the patient at 36 weeks for safe confinementCervix can be replaced inside the vagina* Cervix is to be kept inside the vagina with the help of ring pessary.* Patients should lie with foot end elevated.* To decrease oedema and congestion of the prolapsed mass- gauze soaked with acriflavine and glycerine is to be applied.Cervix is incarcerated and cannot be re-posited* Termination of pregnancy

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