scholarly journals Postpartum Uterine Ultrasonographic Scale: a novel method to standardize the assessment of uterine postpartum involution

2021 ◽  
Vol 14 (4) ◽  
pp. 511-517
Author(s):  
Roxana Covali ◽  
◽  
◽  
Demetra Socolov ◽  
Razvan Vladimir Socolov ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Uterine Cavity ◽  
Cavity Volume ◽  
Time Intervals ◽  
Simple Method ◽  
Uterine Involution ◽  
Postpartum Involution ◽  
Novel Method ◽  
Caucasian Patients ◽  
The Mean

Postpartum hemorrhage is a leading cause of maternal mortality. Various methods can be used to evaluate the postpartum uterine cavity volume. This work aims to introduce a simple method for uterine postpartum cavity volume evaluation, called Postpartum Uterine Ultrasonographic Scale (PUUS), which could be used routinely. In this prospective study, 131 consecutive Caucasian patients were evaluated by using the PUUS method. The mean age was 27.72 years (ranging from 15 to 42). Patients were examined in the same time intervals: within the first 24-48 hours after delivery in case of vaginal delivery, and within the first 48-72 hours, in case of cesarean delivery. Patients with PUUS grades 2, 3, or 4 were reexamined daily until the PUUS grade declined to 1 or 0. The PUUS method evaluated the length of the endometrium of the uterine cavity occupied by blood or debris, from grade 0 (no blood) to grade 4 (over three-quarters of the endometrial length occupied by blood/debris). The PUUS grade of uterine involution varied with the day of examination, gestation, and parity. In this article, a novel method of evaluating uterine postpartum involution titled PUUS is introduced. This method standardized uterine cavity involution in a numerical fashion. We hope that the PUUS scale could further be used to decrease the morbidity and mortality of women due to postpartum hemorrhage.

scholarly journals The Importance of the Novel Postpartum Uterine Ultrasonographic Scale in Numerical Assessments of Uterine Involution Regarding Perinatal Maternal and Fetal Outcomes

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1731
Author(s):  
Roxana Covali ◽  
Demetra Socolov ◽  
Alexandru Carauleanu ◽  
Ioana Pavaleanu ◽  
Mona Akad ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Postpartum Hemorrhage ◽  
Uterine Cavity ◽  
University Hospital ◽  
Obstetrics And Gynecology ◽  
The Novel ◽  
Transabdominal Ultrasonography ◽  
Scale Method ◽  
Uterine Involution ◽  
The Mean

Background: Uterine involution assessments are critical for the prevention of postpartum hemorrhage. Various methods have been used worldwide. Methods: The PUUS (Postpartum Uterine Ultrasonographic Scale) method evaluates, by transabdominal ultrasonography, the length of the endometrium of the uterine cavity occupied by blood or debris, from grade 0 (no blood) to grade 4 (over three-quarters of the endometrial length occupied by blood/debris). A total of 131 consecutive patients admitted for delivery in the Elena Doamna Obstetrics and Gynecology University Hospital in Iasi, Romania, were prospectively evaluated using the PUUS method. The mean age was 27.72 years old, and they were examined during the first 24–48 h after vaginal delivery, or in the first 48–72 h after cesarean delivery. For patients with a PUUS grade greater than 1, re-examination was preformed daily in the following days, until the PUUS grade decreased to 1 or 0. Results: By standardizing uterine involution in a numerical fashion, we precisely demonstrate that uterine involution varied with the method of delivery (vaginal/cesarean) and with the number of vials of oxytocin received intrapartum, but not with the number of vials of ergometrine maleate received, and not with the origin of the parturient (rural/urban).

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 THE EFFECT OF TRANEXAMIC ACID, CARBETOCIN AND ARGON PLASMA COAGULATION ON UTERINE INVOLUTION AFTER REPEAT CESAREAN SECTION

2020 ◽  
pp. 8-14
Author(s):  
Yuliia Slobodian ◽  
Oleg Golianovskyi
Keyword(s):  
Tranexamic Acid ◽  
Argon Plasma Coagulation ◽  
Uterine Cavity ◽  
Argon Plasma ◽  
Cavity Volume ◽  
Plasma Coagulation ◽  
Uterine Involution ◽  
Group I ◽  
Group Ii ◽  
Uterine Body

Repeat cesarean sections (CS) are associated with additional risks of perioperative complications. The aim of our study was ultrasound evaluation of uterine involution in women after repeat traditional cesarean delivery and after repeat CS using argon plasma coagulation and prophylactic use of tranexamic acid and carbetocin. Materials and methods. Prospective cohort study has been conducted on 140 patients who underwent second CS. Group I included 70 women who had repeat CS with the use of argon plasma coagulation and administration of 100 mcg carbetocin after cutting the umbilical cord. Ten minutes before the operation, 15 mg/kg of tranexamic acid was injected intravenously. Group II consisted of 70 women who had traditional CS, 10 IU dose of oxytocin, divided between 5 UI intravenous bolus dose and slow intravenous infusion, was administered after delivery of the baby. A serial ultrasonographic examination was carried out on the 2nd and 5th day of the postpartum period. Results. A study of the dynamics of changes in uterine body and uterine cavity volume revealed a faster rate of uterine cavity involution in group I compared with group II (p<0.05). In group I on the 5th day in comparison to the 2nd day the mean uterine body volume decreased by 27.75%, in group II – by 20.17%. In group I mean uterine cavity volume declined in three days by 21.09%, in group II – 14.22%. Uterine subinvolution was diagnosed in 3 (4,29%) cases in group I and in 19 (27,14%) cases in group II (p<0.05). Faster uterine involution in group I is probably associated with techniques, that were applied during intraoperative period. In addition, 2.86% (2 cases) from the group I versus 31.43% (22 cases) from the group II, needed additional uterotonic therapy after surgery (methylergometrine, misoprostol) (p<0.001). Conclusion. We have found differences in the course of uterine involution in women in group I in comparison with group II, such as significantly smaller uterine length on the 2nd and 5th day, significantly smaller uterine body and uterine cavity volume, faster rates of involution of the uterine cavity during the first 5 days of the postpartum period, thinner anterior uterine wall in the sutured area. We therefore conclude that complex use of tranexamic acid, carbetocin and argon plasma coagulation appears to be effective to maintain adequate uterine involution after repeat CS and prevent postoperative complications.

scholarly journals Ultrasonic control over the course of the postnatal period and diagnosis of obstetric pathology in the bitches

2019 ◽  
pp. 12-19
Author(s):  
S. Cherkavskyi ◽  
S. Vlasenko ◽  
O. Jerochenko
Keyword(s):  
Postpartum Period ◽  
Abdominal Cavity ◽  
Uterine Cavity ◽  
Postnatal Period ◽  
Uterine Wall ◽  
Pelvic Cavity ◽  
Uterine Involution ◽  
Postpartum Involution ◽  
Heterogeneous Tissue ◽  
Amniotic Membranes

The article presents the results of ultrasound examination of uterine females in the postpartum period. It is established that during its physiological course on the 3rd day, the cervix and body of the uterus are placed in the pelvic cavity dorsally with respect to the bladder, and the horns of the uterus - in the abdominal cavity cranially, in the area of - the loops of the large intestine. On the ultrasound it is noted that the horns of the uterus are expanded, with a diameter of 15-18 mm. The walls of the horns are thickened, with sections from 4 mm to 6 mm. Its tissues are of average echogenicity, of heterogeneous consistency. Hypoechoic homogeneous content is observed in the visualized uterine cavity. In females with delayed litter during this period, uterine horns with a diameter of 1.91–1.96 cm were visualized, with a thickened wall that had hypoechoic areas. In addition, the endometrial relief was folded, uneven, and in some places, its desquamated fragments were visualized. Diagnostic sign of delay of litter was the detection in the uterine cavity of tissue structures of amniotic membranes with increased echogenicity. On the 7th day after childbirth, ultrasound signs of metritis were detected on the background of the delay of the litter. The uterine wall reached 3.3–3.9 cm, had a heterogeneous tissue structure and increased echogenicity. In the internal relief of the uterus, areas of desquamated endometrium were visualized and hyperechogenic contents were present in the uterine cavity. It is proved that ultrasound scan of the uterus into the bough is an eff ective method of monitoring the course of postpartum involution and provides early diagnosis of obstetric pathology. The main diagnostic ultrasound indicator for the delay of litter in the boughs is the visualization of the structures of the amniotic membranes in the uterine cavity, hyperechogenic areas and thickening of its walls. The development of postpartum metritis is indicated by signifi cant thickening of the uterus and its mucous membrane, areas of desquamated endometrium and the presence of hyperechoic content in the uterine cavity. Key words: bitch, postpartum period, uterine involution, delay of litter, metritis, ultrasound.

A Simple Method for the Evaluation of Internal Doses in Nuclear Medicine

1974 ◽  
Vol 13 (02) ◽  
pp. 193-206
Author(s):  
L. Conte ◽  
L. Mombelli ◽  
A. Vanoli
Keyword(s):  
Nuclear Medicine ◽  
Close Agreement ◽  
Whole Body ◽  
Simple Method ◽  
Rapid Estimation ◽  
Absorbed Doses ◽  
The Mean ◽  
The Individual ◽  
Estimation Of Risk

SummaryWe have put forward a method to be used in the field of nuclear medicine, for calculating internally absorbed doses in patients. The simplicity and flexibility of this method allow one to make a rapid estimation of risk both to the individual and to the population. In order to calculate the absorbed doses we based our procedure on the concept of the mean absorbed fraction, taking into account anatomical and functional variability which is highly important in the calculation of internal doses in children. With this aim in mind we prepared tables which take into consideration anatomical differences and which permit the calculation of the mean absorbed doses in the whole body, in the organs accumulating radioactivity, in the gonads and in the marrow; all this for those radionuclides most widely used in nuclear medicine. By comparing our results with dose obtained from the use of M.I.R.D.'s method it can be seen that when the errors inherent in these types of calculation are taken into account, the results of both methods are in close agreement.

Predicting Daily Maintenance Dose of Fluindione, an Oral Anticoagulant Drug

1996 ◽  
Vol 75 (05) ◽  
pp. 731-733 ◽  
Author(s):  
V Cazaux ◽  
B Gauthier ◽  
A Elias ◽  
D Lefebvre ◽  
J Tredez ◽  
...  
Keyword(s):  
Effective Dose ◽  
Maintenance Dose ◽  
Successive Approximations ◽  
Hemorrhagic Complication ◽  
Simple Method ◽  
Individual Variations ◽  
Anticoagulant Drug ◽  
The Mean ◽  
Mean Time ◽  
Daily Maintenance Dose

SummaryDue to large inter-individual variations, the dose of vitamin K antagonist required to target the desired hypocoagulability is hardly predictible for a given patient, and the time needed to reach therapeutic equilibrium may be excessively long. This work reports on a simple method for predicting the daily maintenance dose of fluindione after the third intake. In a first step, 37 patients were delivered 20 mg of fluindione once a day, at 6 p.m. for 3 consecutive days. On the morning of the 4th day an INR was performed. During the following days the dose was adjusted to target an INR between 2 and 3. There was a good correlation (r = 0.83, p<0.001) between the INR performed on the morning of day 4 and the daily maintenance dose determined later by successive approximations. This allowed us to write a decisional algorithm to predict the effective maintenance dose of fluindione from the INR performed on day 4. The usefulness and the safety of this approach was tested in a second prospective study on 46 patients receiving fluindione according to the same initial scheme. The predicted dose was compared to the effective dose soon after having reached the equilibrium, then 30 and 90 days after. To within 5 mg (one quarter of a tablet), the predicted dose was the effective dose in 98%, 86% and 81% of the patients at the 3 times respectively. The mean time needed to reach the therapeutic equilibrium was reduced from 13 days in the first study to 6 days in the second study. No hemorrhagic complication occurred. Thus the strategy formerly developed to predict the daily maintenance dose of warfarin from the prothrombin time ratio or the thrombotest performed 3 days after starting the treatment may also be applied to fluindione and the INR measurement.

A COMPARISON OF TWO METHODS FOR MEASUREMENT OF ALDOSTERONE SECRETION RATE IN MAN

1966 ◽  
Vol 53 (2) ◽  
pp. 177-188 ◽  
Author(s):  
P. Lund-Johansen ◽  
T. Thorsen ◽  
K. F. Støa
Keyword(s):  
Urinary Excretion ◽  
Normal Subjects ◽  
Secretion Rate ◽  
Aldosterone Secretion ◽  
Simple Method ◽  
Mean Values ◽  
Pathological Conditions ◽  
Significant Difference ◽  
Derivative Method ◽  
The Mean

ABSTRACT A comparison has been made between (A), a relatively simple method for the measurement of aldosterone secretion rate, based on paper chromatography and direct densitometry of the aldosterone spot and (B) a more elaborate isotope derivative method. The mean secretion rate in 9 normal subjects was 112 ± 26 μg per 24 hours (method A) and 135 ± 35 μg per 24 hours (method B). The »secretion rate« in one adrenalectomized subject after the intravenous injection of 250 μg of aldosterone was 230 μg per 24 hours (method A) and 294 μg per 24 hours (method B). There was no significant difference in the mean values, and correlation between the two methods was good (r = 0.80). It is concluded that the densitometric method is suitable for clinical purposes as well as research, being more rapid and less expensive than the isotope derivative method. Method A also measures the urinary excretion of the aldosterone 3-oxo-conjugate, which is of interest in many pathological conditions. The densitometric method is obviously the less sensitive and a prerequisite for its use is an aldosterone secretion of 20—30 μg per 24 hours. Lower values are, however, rare in adults.

A simple method to determine the mean cluster size in a molecular beam

1991 ◽  
Vol 21 (3) ◽  
pp. 265-269 ◽  
Author(s):  
J. Cuvellier ◽  
P. Meynadier ◽  
P. Pujo ◽  
O. Sublemontier ◽  
J-P Visticot ◽  
...  
Keyword(s):  
Cluster Size ◽  
Molecular Beam ◽  
Simple Method ◽  
The Mean

Staged Management of Severely Displaced Calcaneal Fractures With Transarticular Pinning: A Damage Control Strategy

2021 ◽  
pp. 107110072110130
Author(s):  
Kyeong-Hyeon Park ◽  
Chang-Wug Oh ◽  
Joon-Woo Kim ◽  
Hee-June Kim ◽  
Dong-Hyun Kim ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Kirschner Wire ◽  
Wound Complications ◽  
Calcaneal Fractures ◽  
Simple Method ◽  
Wire Fixation ◽  
The Mean ◽  
Radiographic Union

Background: Severely displaced calcaneal fractures can result in considerable morphology derangement and may be accompanied by soft tissue compromise. Delayed operative restoration of the calcaneal morphology may result in acute retensioning of the damaged soft tissue with associated wound-related complications. In this study, we describe a staged treatment of displaced intra-articular calcaneal fractures that uses temporary transarticular Kirschner wire (K-wire) fixation and staged conversion to definite fixation. Methods: We identified all of the patients who were treated at our institution for calcaneal fractures between 2015 and 2019. A total of 17 patients with 20 calcaneal fractures were selectively treated with 2-stage management. Temporary transarticular K-wire fixation was performed 24 hours after the injury to restore calcaneal morphology and the surrounding soft tissue. After the soft tissue was considered safe, delayed open reduction and internal fixation was performed. The time to definite surgery, radiographic alignment, wound complications, time to radiographic union, and hindfoot American Orthopaedic Foot & Ankle Society (AOFAS) scores were recorded. Results: The average follow-up period was 17 months (range, 12-43). The average Böhler angle increased from a mean of −22 degrees (range, −109 to 25) to 25 degrees (range, 0 to 47) after temporary transarticular K-wire fixation. The mean time from temporary pinning to conversion to definite internal fixation was 20 (range, 10-32) days. There were no immediate postoperative complications. The average time to radiographic union was 13.7 (range, 10-16) weeks. The mean AOFAS score was 87 (range, 55-100). No infections or wound complications were reported during the follow-up period. Conclusion: Temporary transarticular pinning for staged calcaneal fracture treatment is safe and effective in restoring the calcaneal morphology. This novel and relatively simple method may facilitate delayed operation and decrease wound-related complications. Level of Evidence: Level IV, retrospective case series.

scholarly journals Comparison of Bite Force in Patients After Treatment of Mandibular Fractures With 3-Dimensional Locking Miniplate and Standard Miniplates

2019 ◽  
Vol 1 (1) ◽  
pp. 7-10
Author(s):  
Gaurav Singh ◽  
Madan Mishra ◽  
Amit Gaur ◽  
Dhritiman Pathak
Keyword(s):  
Treatment Strategies ◽  
Bite Force ◽  
Mandibular Fractures ◽  
Time Intervals ◽  
Experimental Conditions ◽  
3 Dimensional ◽  
The Mean ◽  
Group 2 ◽  
Drilling Conditions ◽  
Group 1

Background: Fractures of the mandible can be studied and described in anatomic terms, functional considerations, treatment strategies, and outcome measures. The performance of any fixation system depends on multiple factors including plate adaptation, screw placement, bone quality, drilling conditions, and postoperative patient compliance. Bite force assesses masticatory muscle function under clinical and experimental conditions. Method: 30 patients with isolated, noncomminuted mandibular fractures were randomly divided into two equal groups. Group 1 patients were treated using 3-dimensional locking miniplates and group 2 patients were treated with standard miniplates. The bite forces were recorded at definite time intervals: preoperatively, and second week, sixth week, third month, and sixth month postoperatively. Result: At 6 weeks postoperative, 3 month postoperative, and 6 month postoperative, the mean bite force was found to be significantly higher among group 1 patients as compared to those in group 2 in all the sites. While at 2 week postoperative, the mean bite force was found to be significantly higher in Group 2 as compared to Group 1 at incisor region. Conclusion: The overall results of the present study show better performance in bite force for the 3-dimensional locking miniplate when compared with standard miniplates.

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