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Ultrasonic evaluation of the uterus and uterine cavity after normal, vaginal delivery
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
2001 In: Ultrasound Obstet Gynecol, Vol. 18, 491-498 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2001. Vol. 18, 491-498 p.
URN: urn:nbn:se:uu:diva-95791OAI: oai:DiVA.org:uu-95791DiVA: diva2:170133
Available from: 2007-04-19 Created: 2007-04-19Bibliographically approved
In thesis
1. Postpartum Ultrasound
Open this publication in new window or tab >>Postpartum Ultrasound
2007 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Postpartum Ultraljud
Abstract [en]

This study was undertaken to investigate the involutional changes of the uterus and uterine cavity by ultrasound (US), gray-scale and Doppler, after normal delivery, and to compare with the corresponding findings from women with puerperal complications, particularly retained placental tissue (RPT). The overall design was exploratory and prospective, with the use of descriptive statistics for analysis.

Forty-two women with uncomplicated vaginal term delivery were examined on post-partum days 1, 3, 7, 14, 28 and 56. The AP diameters of the uterus and uterine cavity and morphological findings were recorded. The maximum AP diameters of the uterus and uterine cavity diminished from 92.0 mm on day 1 to 38.9 mm at day 56 and from 15.8 mm at day 1 to 4.0 mm at day 56, respectively. The uterus was most often empty in the early and late puerperium while a mixed echo pattern over the whole cavity was found during mid puerperium (I).

Seventy-nine women with secondary post partum hemorrhage (SPH) were examined on the day they presented with clinical symptoms. US revealed an echogenic mass in the uterine cavity in 17 of 18 patients treated surgically and histology confirmed placental tissue in 14 of these. Sixty-one patients with either an empty cavity or mixed echo pattern had an uneventful puerperal course after conservative treatment (II).

AP diameters and morphological findings for 55 women with endometritis, 28 after caesarean section and 20 after manual evacuation of the placenta overlapped extensively with normal references (III).

The physiological vascular involution studied in 45 women after normal delivery showed that PI and RI indices did not change significantly until day 28 postpartum. The presence of at least one uterine artery notch was found in 13.3% of the women at day 1 and in 90.6% at day 56 postpartum (IV).

PI and RI values were measured and compared with reference values in 20 women with clinical suspicion of RPT who were to undergo surgical evacuation. Mean resistance indices were below the 10th percentile for eight of these 20 women, but overlapping was considerable. Doppler US has limited value as a diagnostic tool for RPT. The absence of a hyper-vascular area in the myometrium does not exclude RPT but an echogenic mass in the cavity is a sign of RPT (V).

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2007. 77 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 254
Medicine, Postpartum ultrasound, Uterine artery Doppler, Retained placental tissue, Secondary postpartum hemorrhage, Puerperium, Endometritis postpartum, Cesarean section, Medicin
urn:nbn:se:uu:diva-7830 (URN)978-91-554-6873-6 (ISBN)
Public defence
2007-05-11, Rosénsalen, Institution för kvinnors och barns hälsa, Akademiska sjukhuset Ingång 95, Uppsala, 09:15
Available from: 2007-04-19 Created: 2007-04-19Bibliographically approved

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