TITLE:
Is Postpartum Uterine Involution Impacted by Instrumental or Operative Procedures? Ultrasound Study
AUTHORS:
Virginija Paliulyte, Grazina Stanislava Drasutiene, Diana Ramasauskaite, Daiva Bartkeviciene, Jolita Zakareviciene, Juozas Kurmanavicius
KEYWORDS:
Postpartum Ultrasound, Uterus, Physiology, Pathology, Cesarean Scar
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.13,
November
5,
2018
ABSTRACT: Objectives: Practitioners are continuously concerned with the
differences between the normal puerperium and the uterine involution after
operated deliveries. This prospective observational study pays attention to the
uterine involution period after the instrumental or operative delivery and
compares the results with those observed in uncomplicated labour. Methods: Over two postpartum months 66 women after normal
(48) and complicated (18) labour were examined for repeated uterine parameters.
The analysis was performed using SPSS version 21. Results: There was no statistically significant difference
between the median uterine size parameters or the uterine artery indices after
the normal delivery and instrumental/operative uterine manipulations during the
involution period, except for a faster declining trend observed in anteroposterior
diameter within the first month after normal labour. The diastolic notch was
more frequent in early puerperium after complicated labor, but less frequent
later. The diastolic notch did not appear in all the postpartum women even two
months after labour. There was evidence of more frequent gas detected in the
pathological rather than in the physiological group. Conclusion: Postpartum uterine involution is not impacted by
instrumental or operative procedures. After complicated labour gas appearance
is more common, but it does not necessarily indicate the presence of endometritis
or retained placental tissues.