An echographic evaluation during the early puerperium of the uterine wound after caesarean section

Burger, N. Francois V.; Darazs, B.; Boes, E.G.M.

doi:10.1002/jcu.1870100605

Cited by 38 publications

(34 citation statements)

References 1 publication

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“…3. Several echogenic dots at the incision site, which is related to the type of closure and the suture material used 82,90,97 (Figs 17A and B). All these characteristics are normal findings and no correlation with pathological conditions is found.…”

Section: Cesarean Sectionmentioning

confidence: 99%

Postpartum Ultrasound

Mulic‐Lutvica¹

2012

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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This article describes uterine and uterine cavity changes throughout the normal and pathological puerperium, as revealed by various ultrasound modalities. A gray scale ultrasound, color and pulsed Doppler ultrasound and 3D ultrasound were used. It is based on results of several prospective longitudinal studies, which were designed so that every woman was examined at six occasions during the puerperium, namely on postpartum days 1, 3, 7, 14, 28 and 56. The first four examinations were performed transabdominally and the last two transvaginally. The same design was used in all studies. The involution process of the uterus was assessed by measuring the anteroposterior diameter of the uterus and uterine cavity. Morphological findings were recorded. The influence on the involution process of parity, breastfeeding, maternal smoking and infant's birth weight were also evaluated. Besides conventional ultrasound, Doppler technology was used to study hemodynamic events occurring during the normal puerperium. The pulsatility (PI) and resistance (RI) indices in the uterine arteries were measured, and the presence or absence of early diastolic notches was recorded. A hypervascular area in myometrium was assessed by color and power Doppler. Normal involution process was also described by means of 3D ultrasound. The volume of the uterus and uterine cavity after normal vaginal delivery were measured using virtual organ computer-aided analysis (VOCAL) using six adjacent planes and a 30° rotation method. Reference values from uncomplicated puerperium were used when pathological conditions were studied.Results from these studies, which shed light on normal and pathological changes during the puerperium, are summarized in this chapter.

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Section: Cesarean Sectionmentioning

confidence: 99%

Postpartum Ultrasound

Mulic‐Lutvica¹

2012

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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“…Three series described the bladder-flap hematoma [2,4,5] without mentioning the subfascial hematoma, and a recent study [6] implied that the subfascial hematoma is an extension of the bladder-flap hematoma.…”

Section: Twelvementioning

confidence: 99%

Sonography of subfascial hematoma after cesarean delivery

Wiener¹,

Bowie²,

Baker³

et al. 1987

American Journal of Roentgenology

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“…Burger and associates reported the results of routine sonographic examinations of 48 patients after low transverse cesarean section: 14 patients were observed to have fluid collections, which we believe represented bladder-flap hematomas, located between the bladder and uterus. 5 None of the patients in this series became symptomatic, however. Infected hematomas and larger hematomas may manifest symptoms of fever, leukocytosis, dropping hematocrit, pain, or pelvic mass, prompting the need for pelvic sonography, which results in their identification.…”

Section: Resultsmentioning

confidence: 67%

Sonographic demonstration of bladder-flap hematoma.

Winsett¹,

Fagan²,

Bedi³

1986

Journal of Ultrasound in Medicine

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A bladder-flap hematoma is generally thought of as a blood collection in a potential space located between the urinary bladder and lower uterine segment {vesicouterine space}. These collections can also extend over the bladder and uterus beneath the peritoneal reflection. In this study, ten patients with a bladder-flap hematoma were evaluated for fever, mass, or dropping hematocrit after surgery. No one sonographic appeamnce is specific for bladder-flap hematoma; however, the diagnosis can be made by finding a mass in the extraperitoneal pelvic space in the postoperative patient. (Key words: ultrasonogmphy. pelvic; hematoma, bladder· flap; pelvic mass, hematoma; pelvic surgery, postoperative complications)Although the number of hysterectomies and cesarean sections performed is incre asin g. the number of significant complications is relatively low. 1 • 2 Pelvic hematomas and pelvic abscesses account for a small but significant number of the total complications. We report a specific complication~ a bladder-flap hematoma.The bladder has an intimate relationship to the lower uterine segment. To obtain access to the uterus, the parietal layer of peritoneum that re· fleets over the urinary bladder and the fundus of the uterus is incised with careful caudad deflection of the urinary bladder. Trauma or incomplete hemostasis may lead to postoperative hematoma formation predisposing to infection. 3 While bladder-flap hematomas are a well-known entity among obstetricians and gynecologists, relatively little is written about this complication in the radiographic literature. In a recent article, Baker and associates describe seven cases of bladder-flap hematoma. 4 We report an additional ten cases and expand the criteria for diagnosis of bladder-flap hematoma.

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An echographic evaluation during the early puerperium of the uterine wound after caesarean section

Cited by 38 publications

References 1 publication

Postpartum Ultrasound

Postpartum Ultrasound

Sonography of subfascial hematoma after cesarean delivery

Sonographic demonstration of bladder-flap hematoma.

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