扬州大学：《妇产科学》课程教学课件（PPT讲稿）31 子宫脱垂 Uterine Prolapse

Uterine ProlapseDI WEN M.D.,Ph.D.18447Professor&ChairmanDepartmentOfObstetrics&GynecologyRenjiHospitalAffiliatedto SJTUSchool ofMedicine

Uterine Prolapse DI WEN M.D., Ph.D., Professor & Chairman Department Of Obstetrics & Gynecology Renji Hospital Affiliated to SJTU School of Medicine

DefinitionThe uterus graduallydescends in the axis of thevagina taking the vaginalwall with it. It may presentclinically at any level,but isusually classified as one ofthree degreesUterineProlapse

Uterine Prolapse 2 The uterus gradually descends in the axis of the vagina taking the vaginal wall with it. It may present clinically at any level, but is usually classified as one of three degrees. Definition

AntevertedUterusThe uterus is approximatelyat right angles to the vaginaand has a slight forwardcurve.UterineProlapse

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RetropositionThe uterus is displacedbackwardsbut thedirectionof its axis remains the sameUterineProlapse

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RetroversionThe long axis of the uterusis directed backwards

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RetroflexionThe uterus is curved backwards. The cervixmay remain in the normal position but isusually positioned as in retroversion

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Causes1. The stretching of muscle and fibroustissue2. Increased intra-abdominal pressure3. A constitutional predisposition tostretching of the ligaments as aresponsepresumablyto yearsin theerectpositionUterineProlapse

Uterine Prolapse 7 Causes 1. The stretching of muscle and fibrous tissue 2. Increased intra-abdominal pressure 3. A constitutional predisposition to stretching of the ligaments as a response presumably to years in the erect position

SacrumUterosacralCardinalligamentligamentSidewallofpelvisPelvic floor8

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SacrumStretchedStretcheduterosacralcardinalligamentligamentStretching andgaping pelvic floor

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In recent years,theincidenceofprolapse is greatly reduced. Themore liberal use ofcaesareansection and the elimination oflabours are probably the two mostimportantfactors.10UterineProlapse

Uterine Prolapse 10 • In recent years,the incidence of prolapse is greatly reduced. The more liberal use of caesarean section and the elimination of labours are probably the two most important factors