How to check for uterine prolapse after childbirth

Written by Zhang Lu
Obstetrics
Updated on February 04, 2025
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During routine postnatal checks after natural childbirth, it is important to evaluate the recovery of pelvic floor function, including checking for the presence and severity of uterine prolapse. Uterine prolapse can be assessed in the following ways:

First, a gynecological examination can be conducted. Through this examination, the condition of the uterine prolapse and the position of the cervix can be clearly identified and staged.

Second, performing a perineal ultrasound can generally assess the condition of uterine prolapse and the state of pelvic floor function.

Third, in cases of severe uterine prolapse, it is also necessary to perform a urinary system examination, such as urodynamic testing, because uterine prolapse often occurs simultaneously with bladder prolapse.

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Written by Du Rui Xia
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Can postpartum constipation cause uterine prolapse?

If there is severe constipation after childbirth, and it is not corrected in time, long-term constipation can lead to uterine prolapse in women. Postpartum constipation increases abdominal pressure, which affects the recovery of pelvic floor muscles, causing the loss of support in the pelvic floor muscles and thus leading to uterine prolapse. However, the main factor contributing to uterine prolapse is not constipation but the damage caused by childbirth, which is the primary cause. After childbirth, the pelvic floor muscles are weakened. Whether standing, bearing weight, or holding breath for a long period, thereby increasing abdominal pressure, can lead to the inability of the pelvic floor tissues to support and stabilize the internal organs of the pelvis, resulting in a prolapse.

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Written by Shen Li Wen
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Can you get pregnant with uterine prolapse?

When women experience uterine prolapse, if it is only mild or moderate, it usually does not affect their ability to become pregnant normally. In most cases, when the woman lies down, the protruding part of the uterus might naturally retract, or it can be manually pushed back into the vagina. During intercourse, after ejaculation, the cervix may still be immersed in semen, allowing sperm to pass through the cervix smoothly, and the woman can become pregnant normally. However, in cases of severe uterine prolapse, such as when the entire uterus descends outside the vagina, and cannot be repositioned back into the vagina even when lying down, during intercourse, the ejaculated semen may not sufficiently immerse the cervix, and sperm may not be able to normally enter the cervix and uterine cavity. Additionally, many women with severe uterine prolapse might experience cervix erosion, bleeding, and infection due to friction, which can produce inflammatory cells that hinder the normal passage of sperm, leading to difficulties in conception.

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Written by Shen Li Wen
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Can you still have children with uterine prolapse?

Most women with uterine prolapse are not affected in their ability to become pregnant and give birth normally. However, in rare cases, symptoms can be severe when women suffer from uterine prolapse, with part of the uterus protruding outside the vagina. This may cause friction with the underwear, leading to localized ulcers or even infections, causing purulent vaginal discharge or bleeding. This can affect the normal passage of sperm and impact normal pregnancy. For these women, anti-inflammatory treatment can be administered first. After healing, it generally does not affect normal conception. After conception, as the size of the uterus increases and moves from the pelvic cavity into the abdominal cavity, the symptoms of uterine prolapse tend to decrease.

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Does uterine prolapse affect pregnancy?

Under normal circumstances, it is still necessary to determine the degree of uterine prolapse to understand whether it affects pregnancy. If the degree of uterine prolapse is mild, and it is just the cervix bulging into the vaginal wall, it generally does not have a significant impact on a normal pregnancy. If the uterine prolapse is more severe, and part of the cervix or part of the uterus has prolapsed beyond the hymen, this condition is considered to be within a mild range of 2nd to 3rd degree of prolapse. This severity of uterine prolapse can greatly impact pregnancy, and it is very easy to lead to miscarriage after becoming pregnant. Therefore, it is still necessary to undergo surgical repair before attempting to conceive.

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Can pelvic organ prolapse be detected by ultrasound?

For uterine prolapse, ultrasound examination mostly cannot detect it. The preferred method of examination for uterine prolapse is gynecological examination. Gynecological examination can observe the position of the vaginal cervix, effectively assess uterine prolapse, and determine its grade. This helps to clarify whether it is a prolapse of the anterior uterine wall, the posterior uterine wall, or the uterus itself. Based on the results of the examination, the next step in the treatment plan can be formulated. In cases of severe uterovaginal prolapse, surgical treatment may be necessary when required.