What is the main risk factor associated with uterine prolapse?

• A. Pelvic inflammatory disease
• B. Intrauterine contraceptive use
• C. Tubal ligation
• D. Pregnancy

Answer: (D)

Uterine prolapse occurs when the pelvic floor muscles and ligaments that support the uterus become weak, causing the uterus to descend into the vaginal canal. Pregnancy is a significant risk factor for uterine prolapse for several reasons. During pregnancy, the pressure on the pelvic floor increases due to the growing uterus, which can weaken the supporting structures. Moreover, the physical changes and hormonal influences during pregnancy, especially during labor and delivery, can further exacerbate this weakening, leading to an increased risk of prolapse.

The experience of childbirth, particularly multiple childbirths, carries a higher risk as well, as each delivery can stretch and strain the pelvic muscles and ligaments. This cumulative effect over time can heighten the likelihood of supportive tissue failure, ultimately resulting in prolapse.

In contrast, conditions such as pelvic inflammatory disease, intrauterine contraceptive use, and tubal ligation have less direct association with the weakening of pelvic support structures, making them less relevant as main risk factors for uterine prolapse.