Is Postpartum Uterine Involution Impacted by Instrumental or Operative Procedures? Ultrasound Study  

作　　者：Virginija Paliulyte Grazina Stanislava Drasutiene Diana Ramasauskaite Daiva Bartkeviciene Jolita Zakareviciene Juozas Kurmanavicius 

机构地区：[1]Clinic of Obstetrics and Gynecology of Vilnius University, Vilnius, Lithuania [2]Centre of Obstetrics and Gynecology, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania [3]Department of Obstetrics, University Hospital Zurich, Zurich, Switzerland

出　　处：《Open Journal of Obstetrics and Gynecology》2018年第13期1289-1304,共16页妇产科期刊（英文）

摘　　要：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.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.

关 键 词：POSTPARTUM ULTRASOUND UTERUS Physiology Pathology CESAREAN Scar 

分 类 号：R73[医药卫生—肿瘤]