Physiological Uterine Involution in Primiparous and Multiparous Women: Ultrasound Study

Abstract

Purpose To examine the uterine involution period after uncomplicated delivery in primiparous and multiparous women. Methods Longitudinal prospective study. Repeated parameters were measured and endometrial contents and diastolic notch were observed. Measurements of primiparous and multiparous women were carried out after labour on the 1st, 3rd, 10th, 30th, 42nd, and 60th postpartum days. The analysis was performed using SPSS version 21. Results The median uterus parameters are bigger in multiparous group in physiological puerperium, but the decreasing trend is the same. The endometrial cavity on the 10th day was significantly wider in multiparous women and mainly echo-negative view of the uterine cavity was observed. The evaluation of the uterine angle deviation changes from an extremely retroverted position to a more anteverted position. RI of the uterine artery in both groups was low immediately after labour and significantly increased one month postpartum. Notching of the uterine artery undergoes changes, but diastolic notch does not appear in all postpartum women even after two months following labour. Conclusions The puerperium period after normal vaginal delivery depends on parity. The trend of involution in primiparous and multiparous women follows a similar pattern, yet, it lasts longer in the multiparous women. Ultrasound of uterine is certainly a useful tool after labour and may be important in facilitating an early detection of postpartum uterine complications.

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

“…Scholars are still looking for the indicators defining the view of the completeness of the uterine incision healing [19] [20] [21]. Are the fluid inserts at the scar location likely to be the signs of incomplete healing?…”

“…The largest changes of the scar occur within the first month after C/S. It is difficult to compare the data as other authors deal with the monitoring interval ranging from week 1 to 6 after C/S or later [19] [20] [21]. We have measured the length and the width of the scar from the early puerperium, because the niche view (recorded by other authors) in our study starts to be determined just from 30 th or 42 nd postpartum days.…”

“…The aim of this study is to compare the metrical quantitative and qualitative characteristics of the uterus in the puerperium period in women after normal vaginal deliveries (according our previous study) with those observed after pathological labour [21]. The second purpose is to draw attention to the uterus after pathological labour and to find useful guidelines facilitating the monitoring of these patients during the involution period.…”

Estudio transversal para determinar la relación entre el estado nutricional antropométrico de un grupo de mujeres lactantes de Medellín y el perfil de ácidos grasos de su leche materna madura

“…La circunferencia de la cintura es un indicador que se asocia a riesgo de padecer enfermedad cardiovascular, el valor promedio obtenido en este estudio fue de 83,2 (8,9) cm y el 64% de las madres presentaron riesgo alto de padecer alguna enfermedad cardiovascular según este indicador, ya que presentan obesidad central (CC>80cm) (Tabla 1). Sin embargo, se podría pensar que el tamaño del útero puede influenciar tal vez esta medida, pero según el estudio realizado por Paliulyte et al a través de un examen ultrasonográfico en serie hasta 2 meses posparto, encontraron que la involución del útero se da rápidamente durante los primeros 30 días y es constante hasta 60 días después del parto 52 . Luego de que este órgano reduce de tamaño y el organismo se adapta a las nuevas condiciones, cerca del 33% de la grasa visceral anterior al embarazo permanece, además las mujeres que ganan mayor peso durante la gestación que el recomendado por IOM 36 tienden a incrementar adiposidad abdominal y mayor grasa visceral abdominal en el posparto 52 , con los riesgos que esto acarrea para la salud futura de la madre.…”

Efficacy of Oxytocin Massage on Involution of Uterus Among Postnatal Mothers

“…Promptly following delivery, the uterus turns out to be irm and withdraws with substitute solidifying and relaxing. The uterus measures around 20 × 12 × 7.5 cm 3 (length, expansiveness and thickness) and weighs around 1,000 g. Toward the inish of about a month and a half, its estimation is practically like that of the non-pregnant state and weighs around 60 g. The placental site contracts quickly introducing a raised surface which measures about 7.5 cm and stays raised even at about a month and a half when it measures about 1.5 cm (Paliulyte et al, 2017). The pace of involution of the uterus can be surveyed clinically by noticing the stature of the fundus of the uterus comparable to the symphysis pubis.…”