Sonography of the puerperal uterus.

Lavery, J. Patrick; Shaw, L

doi:10.7863/jum.1989.8.9.481

Cited by 28 publications

(23 citation statements)

References 3 publications

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“…The ultrasonographic appearance of prominent uterine vascular channels in the normal early postpartum period has been previously described. 3 These vessels are easily visible as tubular myometrial structures in which venous flow may be demonstrated with duplex or color Doppler ultrasonography. By the mid-postpartum period (third and fourth postpartum weeks), we found that myometrial vessels were much less prominent.…”

Section: Discussionmentioning

confidence: 99%

“…Uterine dimensions also were statistically unrelated to infant birth weight in our series, although a correlation had been noted in one previous smaller study. 3 In conclusion, accurate real-time ultrasonographic measurement of the early postpartum uterus requires awareness of extreme uterine susceptibility to distortion by even minimal pressure from the hand-held transducer. In the early postpartum period, the sagittal dimension may be measured accurately and re-WACHSBERG ET AL 221 producibly if segmental measurements about the site of uterine angulation are obtained with a sector probe.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Real-time ultrasonographic analysis of the normal postpartum uterus: technique, variability, and measurements.

Wachsberg

Kurtz

Levine

et al. 1994

Journal of Ultrasound in Medicine

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We evaluated normal uterine involution prospectively with real-time ultrasonography in 100 women after uncomplicated term vaginal delivery. Transducers easily distorted the spongy uterus during early postpartum scanning, an effect minimized with sector transducers that are superior to linear or convex probes for accurate early postpartum uterine measurement. Long-axis measurements correcting for uterine angulation were the most reproducible and accurate, irrespective of bladder distention. Uterine T o our knowledge, only three studies have addressed ultrasonographic measurement of normal postpartum uterine dimensions. 1-J Since only static scanners were utilized in these studies, the reported dimensions bear uncertain relevance to real~time ultrasonography owing to two factors: (1) The long axis of the postpartum uterus often is oriented obliquely rather than parallel to the sagittal plane of the body." Imaging in standard orthogonal planes may therefore underestimate the true sagittal uterine dimension. (2) Our initial real-time ultrasono--graphic observations indicated that the early postpar- contractions caused instability of particularly the transverse dimension. Increasing maternal parity was associated with slightly but significantly larger uterine dimensions up to 4 weeks post partum. The uterus reassumed nongravid dimensions by 6 to 8 postpartum weeks. Uterine involution was unrelated to infant birth weight or breast feeding. KEY WORDS: Uterus, ultrasonography; Uterus, size; Puerperium; Uterine involution; Obstetrics, ultrasonography; Pregnancy, ultrasonography. tum uterus is highly susceptible to distortion from trivial pressure applied via hand-held transducers as opposed to articulated-arm probes that glide across the abdominal skin surface without producing distortion.In each of the cited studies the sagittal dimension apparently was measured without correction for an~ gulation of the uterus as it arches over the sacral promontory in the early postpartum period. l -3 Moreover, uterine dimensions were markedly discrepant between studies, particularly the mean sagittal dimension, which varied from 17.3 to 21.2 cm in the early postpartum period.t. 2 In two studies the sagittal dimension was measured from the fundus to the internal cervical OS,2.3 apparently excluding the cervix, which was incorporated into the sagittal measurement in the other study. 1 Citing unspecified effects of bladder distention on uterine measurements, previous investigators scanned subjects at varying degrees of bladder fullness ranging from emptyJ to moderately distended' to full.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Real-time ultrasonographic analysis of the normal postpartum uterus: technique, variability, and measurements.

Wachsberg

Kurtz

Levine

et al. 1994

Journal of Ultrasound in Medicine

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“…3,4,[11][12][13] In the first week postpartum, the endometrium may be thick, measuring greater than 10 mm, and in up to 51% of patients, an echogenic endometrial mass may be present. 3,4 Sonographic evidence of gas within the endometrial cavity can also be a normal finding after spontaneous vaginal delivery.…”

Section: Discussionmentioning

confidence: 99%

The Sonographic and Color Doppler Features of Retained Products of Conception

Durfee

Frates

Luong

et al. 2005

Journal of Ultrasound in Medicine

108

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Objective. The purpose of this study was to identify the sonographic features of retained products of conception (RPOCs). Methods. Cases of clinically suspected RPOCs referred for pelvic sonography between September 1994 and July 2001 were identified. Patient age, indication, gestational age at delivery, and days postpartum were recorded and sonographic findings were reviewed. Outcomes were determined from medical records and pathology reports. Results. One hundred sixty-three cases were identified. Indications for pelvic sonography included vaginal bleeding in 82 (50%), pelvic pain in 77 (47%), and fever in 55 (34%). Gestational age at delivery ranged from 14 to 43 weeks (mean, 37 weeks), and the sonographic examination was performed from 0 to 95 days postpartum (mean, 21 days). Thirty-six patients underwent surgical intervention, and 28 of these had RPOCs. The remaining 127 patients were followed clinically. An endometrial mass was the most sensitive (79%) and specific (89%) sonographic feature for RPOCs. The isolated finding of either complex fluid in the endometrial canal or a thick endometrium measuring greater than 10 mm had low sensitivity, specificity, and negative and positive predictive values. None of the patients with RPOCs had normal sonographic findings. The absence of an endometrial mass or complex fluid and an endometrial thickness of less than 10 mm were considered normal findings. Color Doppler flow was detected in the endometrium somewhat more often when RPOCs were present than in the absence of RPOCs (75% versus 40%). Conclusions. An endometrial mass is the most sensitive finding for RPOCs. If no mass or endometrial fluid is seen and the endometrial thickness is less than 10 mm, RPOCs are extremely unlikely. The absence of blood flow does not exclude the diagnosis of RPOCs.

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“…Numerous research studies have been performed to try to identify retained products of conception and predict which patients are at risk for postpartum hemorrhage based on the sonographic appearance of the endometrial cavity 1,3,4 . However, few studies have described the normal appearance of the postpartum uterus and endometrial cavity, making it difficult to interpret scans obtained in the setting of postpartum bleeding 1,5,6 .…”

Section: Introductionmentioning

confidence: 98%