Uterine cervical elongation and prolapse during pregnancy: an old unsolved problem.

Prolapse with elongation of the cervix is a rare complication of pregnancy. Prolapse that existed before onset of pregnancy will usually resolve spontaneously by the end of the second trimester, without further complications. A pessary can be used to protect the cervix. Prolapse that develops during pregnancy is usually first noted in the third trimester, and management consists of bed rest in a slight Trendelenburg position. In these cases, pessaries will probably not remain in place or prevent preterm labor. Patient discomfort, urinary tract infection, acute urinary retention, premature labor, and prenatal loss are still major complications, and prolapse usually persists or recurs after labor. Treatment depends on the severity of the condition and the patient's preference.