(Ultrasound Review) The aim of this research, published in Ultrasound in Obstetrics and Gynecology, was to establish the ultrasound appearances at specific time intervals following delivery in women making an uncomplicated postpartum recovery.
There has been no recent research into the usual uterine changes that are demonstrated at ultrasound following delivery. The use of ultrasound has been restricted to the assessment of the uterus in women with abnormal postpartum bleeding or pain suspected of having retained products of conception. This inquiry evaluates not only the changes in uterine and cavity size but also the cavity contents' appearance over a three-week period.
The 40 women studied graded their postpartum bleeding during the course of the research, and this was compared to the uterine appearance. The women presented with a partially full bladder for a transabdominal ultrasound examination on days 7, 14, and 21 postpartum.
Measurements were made of the uterus and the uterine cavity, from which the volume was calculated. An assessment of the echogenicity and regularity of the uterine cavity contents also was made. No significant statistical correlation was found between the duration or amount of bleeding and the size of the uterus. "The presence of an echogenic mass was not associated with heavier bleeding at the time of any of the scans," the authors wrote.
"In this study, ultrasound evaluation of the uterine cavity revealed an echogenic mass in 51% of women with normal postpartum bleeding at 7 days, 21% at 14 days, and 6% at 21 days after fetal delivery," the study said.
This finding is rather alarming considering that echogenic cavity contents is the ultrasound criteria presently used to determine the presence of retained products. According to the authors, "It may be that an echogenic mass within the uterine cavity does not always represent retained products of conception, or that products of conception are commonly retained and therefore have little clinical significance in many cases."
"Ultrasonographic evaluation of the postpartum uterus"
A Edwards and D Ellwood
Canberra Clinical School, University of Sydney, The Canberra Hospital, Canberra, Australia
Ultrasound Obstet Gynecol (December) 2000; 16: 640–643
By Ultrasound Review
May 10, 2001
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