Uterine retroversion is relatively common in 15% of women and rarely calls for concern. Such women will normally conceive and remain symptomless, as the pregnancy advances the uterus rotates spontaneously between 14–16 weeks to an anteverted position, thus allowing the growing uterus to expand into the abdomen. However, if the uterus become entrapped in the hallow of the sacrum it is then incarcerated, such uterus fails to return to anterior position. This usually presents as an emergency and requires immediate intervention to reposition the uterus. The risk factors include, deep sacral concavity, pelvic adhesions, uterine malformations, and pelvic tumors. Rectal prolapse is commonly seen in the children and the elderly but can occur at all ages. The risk factors include chronic constipation, severe or chronic cough, and pelvic floor dysfunction and pregnancy a contributory factor. The combination of prolapse of an incarcerated uterus in a rectal prolapse is rare and only one case reported in literature. This is a report of the second case of prolapse of an incarcerated gravid uterus in a rectal prolapse occurred in a 25-year-old multiparous. The prolapse incarcerated uterus with the rectum was reduced through laparotomy and an encirclement suture applied at the anal mucocutaneous margin. The pregnancy was carried to term and delivered via spontaneous vaginal delivery of alive female weighing 2.8 kg. There was also no recurrence of the rectal prolapse.

Keywords: Incarcerated uterus, Live birth, Rectal prolapse, Thiersch suture