scholarly journals Physiological Uterine Involution in Primiparous and Multiparous Women: Ultrasound Study

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
V. Paliulyte ◽  
G. S. Drasutiene ◽  
D. Ramasauskaite ◽  
D. Bartkeviciene ◽  
J. Zakareviciene ◽  
...  
Keyword(s):  
Early Detection ◽  
Uterine Artery ◽  
Uterine Cavity ◽  
Normal Vaginal Delivery ◽  
Postpartum Women ◽  
Uterine Involution ◽  
Ultrasound Study ◽  
Angle Deviation ◽  
Endometrial Cavity ◽  
Multiparous Women

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.

scholarly journals Sonographic Evaluation of Uterine Dimensions in Postpartum Women of Reproductive Age-Study from Enugu, Southeast Nigeria

2020 ◽  
Author(s):  
Chidimma Nonyelum Okwor ◽  
Chuka Chike Agunwa ◽  
Joseph Tochukwu Enebe ◽  
Amaka Obiageli Nnamani ◽  
Ikechukwu Emmanuel Obi ◽  
...  
Keyword(s):  
Radiation Risk ◽  
Uterine Cavity ◽  
Reproductive Age ◽  
P Value ◽  
Postpartum Women ◽  
Test Analysis ◽  
Maternal Risk ◽  
Uterine Involution ◽  
The Mean ◽  
Prospective Longitudinal

Introduction: Uterine involution, a physiological process in which the uterus reverts to prepregnant size, occurs during puerperium. The latter is a time of substantial maternal risk. Ultrasound is considered the most appropriate tool in monitoring the progression of uterine involution because it is cheap, convenient and repeatable with no radiation risk. Aim: To sonographically evaluate the involution of the uterus and uterine cavity in postpartum women in Enugu, Nigeria. Materials and Methods: This was a prospective longitudinal cohort study on 400 postpartum women at the University of Nigeria Teaching Hospital, Enugu, Nigeria. Transabdominal ultrasonography to measure uterine dimensions was done on day 1, day 3 and day 42 of puerperium using a 3.5-5 MHz curvilinear probe of a portable ALOKA ultrasound machine. Statistical analysis was done with the Statistical Package for Social Sciences (SPSS) software version 20.0. The uterine dimensions were expressed as mean±standard deviation and student's t-test analysis was used to compare the values for day 1, day 3 and day 42 of puerperium. Regression analysis was carried out to measure the relationship between uterine measurements on days 1, 3 and 42. A p-value of <0.05 was considered statistically significant. Results: The mean longitudinal, anteroposterior and transverse diameters of the uterus at day 1 were 14.51 cm, 8.54 cm and 10.97 cm, respectively. The corresponding values for day 42 were 8.27 cm, 4.78 cm, and 6.22 cm. The uterine diameters decreased significantly as puerperium advanced (p<0.001). The mean uterine cavity diameters also decreased significantly as puerperium advanced (p<0.001). There was significant regression between longitudinal diameters of both uterus and uterine cavity on days 1 and 3 but not between days 3 and 42. Conclusion: This study has established a normal range of diameters for the uterus and uterine cavity on day 1, day 3 and day 42 of puerperium. It can serve as reference data for further studies in the study area.

scholarly journals B-mode and Doppler Ultrasonographic Assessment of Uterine Involution in Ewes Treated with Two Different Doses of ProstaglandinF2α

2020 ◽  
Vol 48 ◽  
Author(s):  
Gamze Evkuran Dal ◽  
Sinem Ozlem Enginler ◽  
Ali Can Cetin ◽  
Kerem Baykal ◽  
Ahmet Sabuncu
Keyword(s):  
Real Time ◽  
Uterine Artery ◽  
Doppler Ultrasonography ◽  
Uterine Cavity ◽  
Resistance Index ◽  
Control Group ◽  
Uterine Involution ◽  
Pulsed Wave Doppler ◽  
D Values ◽  
Group 1

Background: Several studies consisted of postmortem evaluations and B-mode ultrasonography have been performed on ovine uterine involution. However, researches with Doppler ultrasonography are very limited in ewes. Doppler ultrasonography is a non-invasive method which provides information about vascular dynamics of the tissues which cannot be examined by B-mode ultrasonography. The aim of the study was to evaluate the effects of two different PGF2α doses on uterine measurements by real time B-mode ultrasonography; and on uterine artery hemodynamics by pulsed-wave Doppler analysis during postpartum uterine involution in ewes.Materials, Methods & Results: The study was conducted with 30 primiparous Kiwircik ewes which lambed singleton without any complication. The ewes were randomly divided into three groups (n= 10 for each group). A single i.m. injection of 125 μg/sheep PGF2α, 75 μg/sheep PGF2α, and 1.0 mL/sheep sterile saline solution were administered to Group 1, 2, and 3, respectively. The day of parturition was considered as the first day of the study. Examinations were performed on days 1, 2, 3, 7, 14, 21 and 28. Diameters of previously gravid horn and caruncles were measured by real time B-mod ultrasonography. Presence of lochia was also noted. Uterine artery pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D) values were measured by pulsed-wave Doppler ultrasonography. The one-way analysis of variance and Duncan’s test were used for statistical analysis. The mean previously gravid horn diameters of ewes were 8.30 ± 0.16 cm and 1.53 ± 0.07 cm on day 1 and day 28, respectively. Previously gravid horn and caruncle diameters had a similar declining pattern in all groups as involution period proceeded. Involution was mostly completed by day 21. More than 50% reduction in uterine size was achieved in prostaglandin administered groups by day 7. Caruncles were not able to be identified after the second week postpartum. Lochia was observed for a longer period in control group. Uterine artery PI and RI showed fluctuations throughout involution period with a similar pattern among groups. S/D values progressively increased until day 14, then showed a decreasing pattern.Discussion: The effects of different PGF2α doses on uterine measurements and uterine artery hemodynamics during postpartum period were compared in ewes for the first time. The uterine size reduction in prostaglandin administered groups suggested that both PGF2α doses were effective in uterine involution. The last observation of lochia in uterine cavity were achieved by day 7 in prostaglandin administered groups, suggesting both PGF2α doses trigger uterine contractions which lead to the removal of uterine content. Automatic measurements by Doppler device were taken in order to provide uniformity and to prevent operator-based bias. The significantly higher uterine artery PI value found in Group 1 on day 1 might suggest the stimulatory effect of PGF2α administration on uterine contractility synergitically with already released endogenous PGF2α. Uterine artery PI and RI showed fluctuations throughout involution period and reached their peak values on day 14. The increasing S/D values up to day 14 indicated increasing diastolic flow, increasing resistance and decreasing blood perfusion in prostaglandin administered groups. Prostaglandin administered groups tended to show higher hemodynamic parameters throughout the study which suggested a vasoconstrictor effect of PGF2α. In conclusion, PGF2α administration on the day of parturition might have constrictor effects both on uterine artery and myometrium which leads to a reduction in uterine blood flow and a rapid decline in uterine size especially during early puerperium even with a reduced dose.

scholarly journals Retrospective study on socio-demographic factors responsible for acceptance of IUCD among postpartum women

2019 ◽  
Vol 7 (3) ◽  
pp. 882
Author(s):  
Pavan Sable ◽  
Rajendra Bagul ◽  
Alokkumar Singh
Keyword(s):  
Retrospective Study ◽  
Educational Status ◽  
Sociodemographic Factors ◽  
Normal Vaginal Delivery ◽  
Postpartum Women ◽  
Age Group ◽  
Rural Government ◽  
The Government ◽  
Socio Demographic Factors ◽  
Year 2000

Background: Despite the availability of modern and scientific measures, unacceptably high numbers of maternal deaths still occur in developing countries. Spacing methods of family planning may avoid maternal and infant deaths. The Government of India launched postpartum IUCD (PPIUCD) services in the year 2000; although acceptance of Postpartum IUCD is a real concern.Methods: The retrospective study was conducted in rural government hospital in Maharashtra during 2016 - 2017. We analyzed sociodemographic variables and acceptance of Postpartum IUCD among postpartum women. The sample size was 595 (N=595). The sociodemographic factors studied included age, type of delivery, sex of newborn, socioeconomic status, educational status, etc.Results: The total postpartum women included in the study was 595, out of which, 202 (34%) accepted for postpartum IUCD whereas 393 (66%) rejected for the same. The most common age group was 20-25 years (65%), followed by age group 25-30 years (30%). Primipara was the comment group (45%) and normal vaginal delivery was common (95%). The educational status of both, the postpartum women and their husband, showed statistically significant association with acceptance of postpartum IUCD (p<0.05).Conclusions: The acceptance Postpartum IUCD was low (34%). The women’s and their husband’s educational status is an important factor in acceptance of Postpartum IUCD (p<0.05). Due attention should be given to enhancing educational level of women, also effective counselling both for pregnant woman and her husband during ANC is required.

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

2018 ◽  
Vol 08 (13) ◽  
pp. 1289-1304 ◽  
Author(s):  
Virginija Paliulyte ◽  
Grazina Stanislava Drasutiene ◽  
Diana Ramasauskaite ◽  
Daiva Bartkeviciene ◽  
Jolita Zakareviciene ◽  
...  
Keyword(s):  
Operative Procedures ◽  
Uterine Involution ◽  
Ultrasound Study

scholarly journals Assessment of Outcome of Intrathecal Analgesia in Multiparous Women Undergoing Vaginal Delivery

2020 ◽  
Vol 5 (1) ◽  
pp. 153-155
Author(s):  
Sanjay Melville Masih ◽  
Rakesh Kumar Gupta
Keyword(s):  
Vaginal Delivery ◽  
Group Iv ◽  
Normal Vaginal Delivery ◽  
Secondary Outcome ◽  
Group Iii ◽  
Group I ◽  
Significant Difference ◽  
Multiparous Women ◽  
Group Ii ◽  
Intrathecal Analgesia

Background: The present study was conducted to assess the outcome of intrathecal analgesia in multiparous women undergoing vaginal delivery. Subjects and Methods: The present study was conducted among 80 multiparous women ages ranged 18- 40 years. All patients received 0.5 ml of intrathecal injection of 2.5 mg bupivacaine 0.5% and 1 ml dexamethasone 4 mg plus a 0.5 ml adjuvant. The adjuvants in group I patients were 100 μg morphine, 25 μg fentanyl in group II, 5 μg dexmedetomidine in group III and normal saline in group IV (control group). The primary and secondary outcome was the duration of pain relief, the analgesia onset time, the maximum level of sensory block, the visual analogue scale (VAS) was recorded. Results: The mean duration of analgesia in group I was 182.4 minutes, in group II was 170.5 minutes, in group III was 200.4 minutes and in group, IV was 140.2 minutes. The onset of analgesia was 3.9 minutes, 2.8 minutes, 2.7 minutes and 4.5 minutes in group I, II, III and IV respectively. S1 sensory regression time (minutes) was 181.4, 157.4, 185.3 and 130.6 in group I, II, III and IV respectively. Modified Bromage scale 5 minutes, 15 minutes and 30 minutes after IT in all groups was 0.0. VAS was 1.3, 1.6, 1.6 and 3.1 with significant differences in all groups (P< 0.05). There was non- significant difference in mean age, weight, height and gestational age between all groups (P> 0.05). There was a non- significant difference in APGAR 1, 5, umbilical pH immediately after delivery, neonatal HR after 5minute, 15 minutes and 30 minutes in all groups (P> 0.05). Conclusion: The authors found that dexmedetomidine is a safe and effective adjuvant to intrathecal bupivacaine-dexamethasone in multiparous women undergoing normal vaginal delivery.

CLINICAL STUDY OF PRIMARY CESAREAN SECTION IN MULTIPAROUS WOMEN AT OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2021 ◽  
pp. 7-8
Author(s):  
Kumari Nisha ◽  
Renu Jha ◽  
Kumudini Jha ◽  
Debarshi Jana
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Placenta Previa ◽  
Fetal Distress ◽  
Normal Vaginal Delivery ◽  
Major Surgery ◽  
Obstetrics And Gynaecology ◽  
Emergency Cesarean ◽  
Study Results ◽  
Multiparous Women

Background: Caesarean section is the most commonly performed major surgery among women. The aims and objective of this study was to know the incidence of primary Caesarean section in multigravidas, its indications and to know the maternal and foetal outcome among these patients. Methodology: This was an observational study conducted at Department of Obstetrics and Gynaecology of Darbhanga Medical College and Hospital, Laheriasarai, Bihar. Aim of the study was to study the indication, maternal and fetal outcome in primary cesarean in multiparous women. All multiparous women admitted for delivery were included in the study Results: The total number of deliveries were 3064 and cesarean section were 1026 (33%).The total number of primary cesarean section in multiparous women were 84 constituting 2.7%. In this study, majority of women were Gravida 2. 91.6% of the cases were underwent emergency cesarean section and anesthesia was spinal. Majority of patients were between age group of 22 to 27 yrs (70%). Indications for cesarean section in our study were severe oligohydroamnios (22%), fetal distress (15.4%), and breech presentation (14%), premature rupture of membrane (12%).Intra operative ndings were meconium stained liquor, post partum hemorrhage, thinned out lower segment and extension of incision. Out of 84 cases, 48 cases needed intra operative or immediate post operative blood transfusion. The post operative morbidity was present in 6 cases i.e paralytic ileus, puerperal fever, urinary tract infection and wound gaping. Majority of babies, weighed in the range of 2-3kgs (55%).Out of 84 cases 7 were causes were placenta previa, obstructed labor and fetal distress. Conclusion: Many unforeseen complications occur in women who previously had a normal vaginal delivery. It is recommended that all antenatal patients must be booked and receive proper and regular antenatal care. Also 100% deliveries in multigravida should be institutional deliveries in order to reduce maternal and perinatal morbidity and mortality.

scholarly journals The Association between Traditional Chinese Dietary and Herbal Therapies and Uterine Involution in Postpartum Women

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Ming Ho ◽  
Tsai-Chung Li ◽  
Shan-Yu Su
Keyword(s):  
Regression Models ◽  
Uterine Contraction ◽  
Herbal Medicines ◽  
Correlation Coefficients ◽  
Postpartum Women ◽  
Herbal Therapy ◽  
Uterine Involution ◽  
Herbal Therapies ◽  
Special Diets ◽  
Retrospective Questionnaire

Background. Traditional Chinese postpartum care is believed to help in the recovery of women after delivery.Objective. This study investigated the association of elements in dietary and herbal therapy with uterine involution.Methods. Indices of uterine involution were measured ultrasonographically in 127 postpartum women between 4-6 weeks after delivery. A self-reported retrospective questionnaire was used to query women about their frequencies of taking herbal medicines and consuming special diets during the first month after delivery. Correlation coefficients were calculated to identify the associations, then the regression models were used to identify the predictors.Result. Among the herbal medicines and diet, consumption ofEucommia ulmoides(E. ulmoides) negatively correlated with the AP diameter of the uterus and the cavity.E. ulmoideswas also the only predictor of maximum AP diameter of the uterus, AP diameter of the uterus 5 cm from the fundus, and the maximum AP diameter of the cavity. Moreover, consumption of Sheng-hau-tang was significantly correlated with anteverted uterus and was a predictor of anteverted uterus.Conclusion.E. ulmoidesand Sheng-hau-tang positively correlated with the degree of uterine involution after delivery, implying that both therapies might possess the pharmacological efficacy of uterine contraction in postpartum women.

Iatrogenic Endometriosis and Intrauterine Adhesions after Myomectomy

2016 ◽  
Vol 8 (3) ◽  
pp. 236-238
Author(s):  
Farheen Yousuf
Keyword(s):  
South Asian ◽  
Uterine Cavity ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Resonance Imaging ◽  
Intrauterine Adhesions ◽  
Ovarian Endometrioma ◽  
Imaging Results ◽  
Endometrial Cavity ◽  
Cut Surface

ABSTRACT Aims To report a case of iatrogenic endometrioses as a result of improper closure of endometrial cavity during myomectomy. Case Report A 30-year-old para 1 has been self-referred to our institution for medical care. A fibroid protruding the endometrial canal was removed 8 months prior to this hospital admission. In less than a month after initial myomectomy, she began experiencing severe pelvic pain more accentuated during menstruation. The pain became progressively worse. The magnetic resonance imaging results are suggestive of ovarian endometrioma. She underwent total abdominal hysterectomy and bilateral salpingo-oophrectomy. Cut surface of uterine cavity shows obliteration of endometrial canal with hourglass constriction. Conclusion Closure of endometrium during myomectomy should be carefully done; keeping an account on patency of endometrial canal is essential to prevent iatrogenic endometriosis. How to cite this article Yousuf F. Iatrogenic Endometriosis and Intrauterine Adhesions after Myomectomy. J South Asian Feder Obst Gynae 2016;8(3):236-238.

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