Genital prolapse is a frequent pathology. However, its occurrence during pregnancy is exceptional. Uterine prolapse may initially develop during pregnancy, or pregnancy may occur over a pre-existing prolapse. Its occurrence during pregnancy is also rare. In the USA, the incidence is 1 case/10,000-15,000 deliveries [1] - [4] . In the Ivory Coast, according to Koffi, uterine prolapse complicating pregnancy is exceptional. Management requires the use of a pessary, and bed rest is recommended during pregnancy. In the absence of any associated pathology, vaginal delivery is recommended [1] . It differs from pre-existing uterine prolapse, which generally disappears spontaneously at the end of the second trimester without complication [2] . This so-called gravidic or gestational prolapse is thought to be due to physiological changes in the maternal body during pregnancy in a woman with other predisposing risk factors. The prolapse of the gravid uterus makes pregnancy a high-risk pregnancy. Numerous maternal and perinatal complications have been described [2] [5] .

We report a case of genital prolapse during pregnancy received at the maternity ward of the Sourô Sanou University Hospital in Bobo-Dioulasso, Burkina Faso.

Genital prolapse is a frequent pathology; however, the occurrence of prolapse in a pregnant woman is an exceptional situation. In multiparous and/or post-menopausal women, the weakness of the organs of support, suspension, and orientation, as well as the drop in estrogen impregnation, is another associated factor [1] .

Numerous independent risk factors have been identified for the occurrence of this pathology [5] : a history of prolapse during or outside pregnancy, prolonged childbirth, multiple pregnancies, chronic coughing or constipation, repeated or severe physical exertion, and congenital damage to the supporting aponeurotic tissues [6] [7] .

According to Boufettal [8] , a hormone called relaxin, secreted during pregnancy, is involved in the development of connective tissue anomalies leading to ligament hyperlaxity. Thus, even minor obstetrical trauma is likely to aggravate the static anomaly, which could explain the occurrence of genital prolapse in young women.

In our case, in addition to hormonal factors related to pregnancy, the risk factors identified were essentially tachy-multiparity (eighth gesture fifth pare at 32 years of age) and the physical activities undertaken by the patient: living in a rural environment, she is subjected to rural work, carrying heavy loads, etc.

The presence of a prolapse during pregnancy can lead to complications such as childbirth and premature rupture of the membranes. During labour, mechanical obstruction caused by the prolapse can result in cervical oedema, leading to a number of complications, notably mechanical and dynamic dystocia. Cervical lesions and uterine rupture have also been described [9] [10] . In our case, the cervix was inflamed, and there were no other complications.

Our patient was admitted to the CHUSS maternity hospital as an emergency patient, and no emergency treatment was offered. A cautious manual reduction was performed, and advice was given on rest, hygiene, and the reduction of activities. However, the patient had taken up traditional management, using a pot as a “pessary” to reduce the prolapse, and had not considered it necessary to seek medical advice for this condition, which had arisen during the second trimester of her pregnancy.

Generally speaking, the prolapse persisted in the immediate and early postpartum period, with regression of the cervical edema, allowing reintegration of the uterus and use of the pessary [11] . Surgical repair of the prolapse may be proposed at a distance from delivery in patients planning to have children, giving preference to minimally invasive techniques with uterine conservation and without the use of prosthetic reinforcement. In the absence of a desire to become pregnant, conventional non-conservative suspension techniques can be used [5] .

Definitive treatment of the prolapse had been proposed to the patient in the postpartum period, but she was unable to afford it. Counseling for long-term contraception was provided.

Uterine prolapse complicating pregnancy is exceptional. Improving patients’ socio-economic conditions and access to quality antenatal care could considerably improve maternal health, especially for those living in rural areas.