Gina Marciano, a 44-year-old mother of eight children, visited her physician complaining of a 'bearing down' sensation in her pelvis, low backache, and urinary incontinence. A vaginal examination showed that the external os of her cervix was just inside the vaginal orifice and her perineum exhibited large keloids (masses of scar tissue). What do you think Gina's problem is and what caused it? (Be anatomically specific.)

Video transcript

Welcome back, everyone. Let's look at our next question. Uterine prolapse happens when the muscles and connective tissues such as ligaments become weak or damaged, resulting in the descent of the uterus into the vaginal canal, which of the following factors can contribute to the development of uterine prolapse. Choice. A chronic use of hormonal con contraceptives. B, multiple pregnancies and vaginal deliveries. C high levels of estrogen in the body or d, regular exercise and strong pelvic floor muscles. Well, our answer here will be choice. B, multiple pregnancies and vaginal deliveries. The result of these multiple times of being pregnant and delivering can cause a strain on the muscles and connective tissue that support the uterus. And if it's not properly supported, the result can be a prolapse or descent of the uterus into the vaginal canal. When we look at our other answer choices. Choice D is definitely not right because regular exercise and strong pelvic floor muscles can prevent or alleviate some of the prolapse. So choice D definitely not our correct answer choice. A chronic use of hormonal contraceptives uh will affect hormone levels but doesn't cause prolapse. And finally choice C, high levels of estrogen in the body, estrogen does affect muscles and connective tissue, but it's not a cause. So it doesn't cause prolapse. That's more the tremendous strain that's put on those muscles and connective tissues during pregnancy during vaginal delivery. So choice c not correct either. So again, which factors contribute to the development of uterine prolapse. Choice B multiple pregnancies and vaginal deliveries. See you in the next video.