Download to read offline
Uploaded bySurakshya Poudel
Uterine prolapse and its implication on family health
This document discusses uterine prolapse, its causes and prevalence in Nepal. Some key points: - Uterine prolapse occurs when the muscles and ligaments supporting the uterus weaken, causing it to descend from its normal position. - It is common in Nepal, where 26 is the median age of onset. Risk factors include early childbearing, heavy lifting after birth, and lack of nutrition and medical care. - Consequences include pain, stigma, and inability to perform daily tasks. Prevention emphasizes nutrition, rest after birth, and exercises to strengthen pelvic muscles. The government is working to improve access to treatment.
More Related Content
Similar to Uterine prolapse and its implication on family health
Uterine prolapse and its implication on family health
- 1. Uterine Prolapse andits implication on family health Prepared and Presented by: Surakshya Poudel BPH 2nd batch (3rd yr) UCMS
- 2. Introduction • Uterine prolapseis a debilitating form of pelvic organ prolapse(POP) that occurs when the muscles and ligaments that support a woman’s uterus are weakened, resulting in the descent of the uterus from its original position within the body. • UNFPA defines pelvic organ prolapse as “the descent or herniation of the pelvic organ, uterus, rectum or bladder into the vagina”.
- 4. Stages of UterineProlapse Uterine prolapse (UP) is recognized as a form of maternal morbidity, and can be classified into three stages terms of severity. Stage-I: The uterus leaves its place but is still inside the vagina. Stage-II: The uterus leaves its place and comes upto the opening of the vagina. Stage-III:The uterus comes out of the vagina.
- 6. Depending on theseverity of the prolapse, different treatments may be effective: • first and second stage prolapse may be treated with specific exercises which strengthen the pelvic floor or by the insertion a small low cost medical device called a ring pessary. • severe prolapse requires surgical intervention in the form of a vaginal hysterectomy or pelvic floor repair surgery.
- 7. Status of UterineProlapse in Nepal • Uterine prolapse is one of the major public health problem among postmenopausal and women of reproductive age group in Nepal. • In Nepal, according to a study carried out by the UNFPA in 2013, the median age at which Nepali Women first experience uterine prolapse is 26. • The 2006 study conducted by Institute of Medicine (IOM) and United Nation Population Fund (UNFPA) estimates that there may be around 600,000 women with UP in Nepal and 200,000 are in need of immediate care (UNFPA, 2006).
- 8. • In the2006 NDHS survey women aged 15-49 who have had a pregnancy were asked whether they had ever experienced symptoms of UP (patheghar khasne/ang khasne). • In 2006, 7 %of women said they had experienced symptoms of UP while by 2011 the prevalence declined to 6 %.(NDHS,2011)
- 9. Fact sheet aboutUterine Prolapse A 2004 study of field-based health camps in 10 districts of Nepal conducted by the Safe Motherhood Network revealed the following statistics about women affected by uterine prolapse: Among the 415 patients who came for health check-ups, • 70 % represented women from the hilly region and 30 % represented women from the plains • 58 % were Brahmin/Chettris, while the rest were from indigenous groups and Dalits • Although the disease is usually detected among Nepali women aged 25 to 50 years, the study found that a 16 year-old girl and 80 year old woman were also among the patients
- 10. • 86 %of the women were already married by the age of nineteen and among these women, 31 % were women between the ages of 20 and 24 and 19 % were women between the ages of 15 and 19 yrs • 95 % of the women had carried large and heavy loads within 45 days of child birth • 61% of the women had between three and five children • Among the women who visited the health camps, 40 % had one child while 22 % had two children; • Among the 2900 women who went through a health check-up, 10 % were affected by the disease; (Medical Study Institution, 2006)
- 11. • Uterine Prolapsewas more prevalent among women who were deprived of general health services. • Generally Uterine Prolapse occurred because of a lack of nutritious food, appropriate rest, and health services and care. • Lack of health education was also one factor for the high prevalence of the disease.
- 12. Causes of UterineProlapse in Nepal The causes of the high prevalence of uterine prolapse in Nepal are complex and manifold: • Within Nepal, there are various sociocultural norms that expose women to multiple risk factors that decrease the age at which prolapse occurs, and increase the prevalence of the condition within the country. • Nepal is a patriarchal society, within which gender has immediate implications for health and wellbeing throughout one’s life course. • UP in Nepal is also exasperated by poverty and limited access to adequate health care services.
- 13. • A lackof access to skilled health workers that many Nepali women are exposed to harmful birthing practices that heighten their chances of experiencing UP later in life.
- 14. Risk Factors ofUterine Prolapse in Nepal • This condition is more common in women who have had one or more vaginal births. • Carrying heavy loads or strenuously working six weeks after child birth. • Giving birth at a tender age and lack of nutritious food during pregnancy and after child birth • Unsafe abortions • Continuously coughing after child birth • Applying more pressure than required before the time of child birth • Malnutrition, dysentery for a long period, anemia • Lack of rest after child birth.
- 15. Consequences of UterineProlapse in Nepal • The development of UP, if left untreated, leads to severe pain and discomfort. • In many instances these symptoms may manifest as painful intercourse, an inability to sit, walk, and/or stand, difficulties urinating and defecating, odorous discharge and an inability perform daily tasks. • Women in Nepal who suffer from UP often experience emotional and physical abuse from their family and or community because of the stigmatization surrounding the condition.
- 16. • In a2013 UNFPA study which interview 357 women who underwent surgery in Nepal to treat UP, 80% of women said that after having developed the condition they lost hope in life. • Depending on the district, between 5% and 23% of women said that “their mother-in-law and family members started hating them” (UNFPA, 2013). • Owing to the ostracization and stigmatization that women with UP in Nepal experience, many choose to conceal the condition, living in severe pain and discomfort, sometimes for decades.
- 17. Addressing the problem UNFPAand the government of Nepal are working together to develop a three-fold national strategy to tackle prolapse: 1.Improving access to appropriate health care for low-income women, low caste women and women living in conflict areas. 2.Improving the volume and quality of reproductive health care services, including mobile reproductive health camps. 3.Promoting awareness of the issue at community level.
- 18. National Response toPOP • Government of Nepal has recognized POP as a high priority condition and has shown its commitment by creating a fund for provision of free POP surgery services to women in need. • UNFPA and other key stakeholders have been supporting GoN efforts by supporting POP treatment through designated reproductive health (RH) camps and POP surgeries. • From 2008/9 to 2011/12, around 34,000 women have been benefited from POP surgery through GoN supported RH camps • . UNFPA has supported for POP surgery of about 6,700 women and ring pessaries for additional 8,100.
- 19. Prevention The following suggestionsare offered in the prevention of Uterine Prolapse: • Eating nutritious food: Women must eat nutritious food such as spinach, beans, milk, yoghurt, fruits, eggs, fish and meat, etc. Nutritious food is very important for pregnant women and for women after child birth which is widely available in the villages. • Large liquid intake: The intake of liquid is very important because this can clear the stomach and ease pressure on the muscles.
- 20. • Not carryingheavy loads: If there is a need to lift a heavy load, the knee should be used to lift the weight instead of the whole body. Alternatively, it is best to ask someone nearby to help lift the weight unto woman’s back. • Receiving proper rest: There is a need to receive appropriate rest during pregnancy and after child birth. Only light work should be done and heavy loads avoided.
- 21. • Short-delivery period:If the delivery period exceeds more than 12 hours, a health worker must be consulted. Longer delivery periods will put pressure on vaginal and stomach muscles which will weaken them and possibly result in the dropping of the uterus; • Special exercise: In order to prevent the uterus from dropping, special exercise called 'Kagel' can be practiced.