Rectal prolapse during pregnancy. A case report.
BACKGROUND: Rectal prolapse is a bothersome surgical problem that is relatively infrequent. It usually occurs in the fifth to seventh decades of life and is more common in women. CASE: A 33-year-old woman, gravida 3, para 2, was found to have a large rectal prolapse at 33 weeks' gestation. Manual reduction was successfully performed after injecting 2% lidocaine into and around the anal sphincter. Because she could not undergo definitive surgical repair during her pregnancy, the patient was managed with an aggressive stool softening regimen and self-reduction techniques. Labor was induced in the 40th gestational week. Epidural anesthesia was employed, and delivery was accomplished via low-outlet forceps application. The patient underwent definitive surgical repair of the rectal prolapse eight weeks postpartum. CONCLUSION: Rectal prolapse is a rare condition during the childbearing years. We found no prior case reports of rectal prolapse occurring during pregnancy. While childbirth itself is not considered a risk factor for rectal prolapse, a prior history of perineal lacerations may be a risk factor. To manage rectal prolapse that occurs during pregnancy, consideration should be given to passive forceps delivery under epidural anesthesia to avoid the possibility of worsening the prolapse.
Viera, AJ; Larkins-Pettigrew, M
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