EP19.04: Sonographic appearance of the uterus in the early puerperium in vaginal vs Caesarean deliveries: a prospective study

Abstract

Ultrasound may assist in the diagnosis of post-partum pathologies. However, data are scarce regarding the sonographic appearance of the uterus in the puerperal period, according to mode of delivery, and following third stage of labour abnormalities. We described uterine sonographic characteristics in early puerperium, following vaginal vs. Caesarean deliveries; and in women with abnormal third stage of labour, compared to uncomplicated vaginal delivery. This is a prospective study of women after delivery of singleton, appropriate-for-gestational-age weight, term neonates. Sonographic uterine dimensions (height, length and width), intracavitary thickness and its echogenicity (at level of fundus, mid-cavity and cervix) were recorded at less than and after 24 hours from delivery, and compared between women delivered vaginally and by Caesarean delivery. Among women delivered vaginally, data were analysed according to whether women underwent manual revision of the uterine cavity. Of the 99 women included in the study, 33 (33%) delivered by Caesarean section. Sonographic evaluations were taken at 15.4 (4.3-24.0) and 39.5 (28.8-108.8) hours after delivery (median, range). We found no clinically significant differences in uterine characteristics according to mode of delivery or according to manual revision of the uterine cavity. The sonographic appearance of the uterus was similar when performed at less than or after 24 hours from delivery. Postpartum sonographic evaluation of the uterus appears similar after vaginal and Caesarean deliveries.