Sharp Abdominal Pain in Early Pregnancy: What Could It Be?

Question
I am currently 6 weeks 2 days pregnant with an intrauterine pregnancy.  Yesterday I experienced sharp pains across what I thought was the top of my uterus.  The pain was very sharp and intense and was followed by a burning sensation.  I have had previous abdominal surgery in the past due to ectopic pregnancies.   The last surgery was in 2001, at which time my OBGYN advised he had observed a fair amount of adhesions.   My OBGYN feels the pain I felt (which is pretty much gone now) was tearing of the adhesions.   Now today I began to feel pressure in my vagina and felt like everything was 'falling out' and when I did a physical inspection I could feel a downward bulge within my vagina right at the opening.   I pushed the bulge upwards and appears to be staying put.  Is this a possible prolapse of an internal organ?  If so what organ?  What can be done during pregnancy?  This is my 11th pregnancy and I have 3 children.   Any thoughts would be appreciated.

Answer
I doubt that your uterus is prolapsing. It rarely does during a pregnancy, especially as the baby is growing. It is more likely that, due to pressure of the fetus on your bladder, you may be developing a cystocele, which is a weakness of the tissue between the bladder and the vagina. The bladder then bulges out through the vagina. It can be accompanied with some loss of urine when you laugh or cough. The pain you had at the fundus of the uterus was probably due to adhesions from previous surgery, but that would not interfere with the current pregnancy. If it occurs again, have your obstetrician check it out by doing a speculum exam and having you bear down. If it is a cystocele, it will bulge when you bear down. There is nothing you can do during the pregnancy to correct this, except some Kegel's exercises. Discuss it with your doctor.