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

Ans. is c i.e. Ring pessary Other indications of Ring pessary : Young women planning a pregnancy. In puerperium - to facilitate involution. Patient unfit or unwilling for surgery. Women who have undergone atleast one previous attempt at surgical intervention without relief. Diagnostic - It may be placed diagnostically to identify which women are at risk for urinary incontinence after prolapse correcting surgery. Problems associated with pessary : It is never curative and is only palliative. Can cause vaginitis. Has to be changed every 3 months. Forgotten pessary can cause VVF. May cause dyspareunia. It does not cure stress incontinence. Contraindication of pessary : Acute Genital Tract infections. Adherent Retroposition of Uterus. Management of prolapse in a young woman following child bih : Perineal exercise Ring pessary Never do surgery within 6 monthsdeg of delivery as there is always the possibility of recurrence of prolapse.deg