Involution after childbirth is the time spent by the body to restore all systems and organs that have changed during pregnancy and childbirth. Involution in each woman proceeds differently, but on average no more than eight weeks.

To make sure that the recovery is proceeding safely, the doctor prescribes an ultrasound procedure after childbirth. ultrasound - ultrasonography organism, allows you to study in detail the state internal organs.

After the birth of a child, after a few minutes, the placenta is born, and the uterus immediately reduces its size. On the next day after childbirth, the uterine fundus descends and ten days later the uterus takes its former size and position in the pelvic region. The shape of the uterus is an important indicator of involution. On the fourth day after birth, it has the shape of a ball, later becoming oval, and after 8 days it becomes pear-shaped again, as before pregnancy.

Discharges from birth canal(lochia) also mutate, going from bright red to paler and slimier. By the end of the second month after birth, they should completely stop.

Ultrasound after childbirth makes it possible to find out the condition of the reproductive organs and, if a problem is identified, prescribe treatment in a timely manner.

When is an ultrasound done if there was a natural birth

If the birth was natural, in the first few hours, the woman in labor is given an ultrasound scan. heavy bleeding to rule out uterine rupture and diagnose the cause.

If the birth proceeded normally, ultrasound is done on the third day, conducting it transabdominally. If a more detailed examination is necessary, then the study is carried out with a transvaginal sensor.

First of all, the doctor assesses the condition of the uterus. The uzist may notice the presence of placental remnants, membranes or a profuse collection of fluid, which can cause inflammation of the uterus. He also evaluates the size of the uterus and compares them with the norm corresponding to the postpartum period.

On examination, the doctor may note the increased size of the uterus, this is a deviation. If this is not explained by a large fetus or polyhydramnios, for example, then this phenomenon should be considered pathological, and is called uterine subinvolution. Ultrasound will help to find out the cause of such a deviation and enable the obstetrician-gynecologist to prescribe adequate treatment.

The first days, the uterus may not contract enough, which is also found on ultrasound after childbirth. In this case, drugs are prescribed causing abbreviations smooth muscles of the uterus and antispasmodics to ensure a good outflow of lochia.

The detection on ultrasound of the remains of particles of a child's place in the uterine cavity may serve as a reason for curettage or vacuum aspiration. Delay in the procedures is dangerous for the development of inflammation of the uterus - endometritis. Timely ultrasound will help prevent it.

Endometritis after childbirth is diagnosed on ultrasound with the following symptoms: poor uterine contractility, remaining particles of the placenta and fetal membranes. Lost time can cause complex disease- endometritis, so antibiotics and antispasmodics should be prescribed as soon as possible to avoid removal of the uterus and eliminate the threat to the life of the woman in labor.

A common cause of heavy bleeding can be the remaining placental parts and membranes of the fetus, they will be noticed by the doctor performing the ultrasound procedure. Curettage of the uterus will help stop the bleeding.

If a woman in labor has any abnormalities in the first ultrasound, ultrasound is prescribed again during treatment, evaluating its effectiveness. Only after receiving good results, the woman is discharged from the hospital for further medical supervision.

When is an ultrasound done if there was a caesarean section

Caesarean section slows down the return of the uterus to its original state, since during the operation there were violations of the integrity of muscle tissue. The uterus becomes close to its original form only by the 10th day after birth.

Caesarean section increases the risk of various complications: endometritis, bleeding - external and internal. In this regard, ultrasound is of great importance in monitoring the recovery process.

The usual practice is pre-discharge ultrasound for all women in labor. However, an ultrasound after childbirth is also prescribed a little time after the operation, in order to exclude internal bleeding and check the condition of the uterine sutures. Complaints of a woman in labor about pain in the lower abdomen or test results may be the reason for an extraordinary ultrasound. The doctor also examines the postoperative scar.

After repeated ultrasound, the doctor assesses the condition, and with positive dynamics, the woman is discharged under medical supervision.

Ultrasound also evaluates, in addition to the uterus, the ovaries and blood vessels of the pelvic organs.

Ultrasound after delivery

If ultrasound was not performed in the maternity hospital, you should not postpone this procedure, you need to visit a doctor as soon as possible, especially for women in labor who are at risk, in order to exclude the recurrence of complications.

Even if the course of the postpartum period was without pathologies, it is worthwhile to undergo an ultrasound scan at the end of involution for all women who have given birth for preventive purposes.

Indications for ultrasound

Urgent ultrasound requires such signs:

• Increased bleeding;
• An increase in temperature and secretions having bad smell;
• Pain in the area postoperative suture, liquid oozing from it, as well as redness and swelling of the seam.

postpartum period - this is the period of time during which a woman who has given birth undergoes a reverse development (involution) of those organs and systems that have undergone changes in connection with pregnancy and childbirth. Usually this period, taking into account individual features begins immediately after separation of the placenta and lasts up to 6 weeks.

Immediately after the birth of the placenta, the uterus decreases significantly in size. her bottom ( top part) at this point is at the level of the navel. The next day after childbirth, the bottom of the uterus drops somewhat and is located just below the navel. On the 4th day, it is already determined in the middle between the navel and the womb. On the 8-9th day, the bottom of the uterus can still be felt at the level of the womb or slightly above it. An important indicator is a change in the shape of the uterus. On the 3rd day after birth, it is spherical, by the 5th day it is oval, and by the 7th day it becomes pear-shaped, as before pregnancy.

Changes are also observed in the nature of the discharge from the genital tract (lochia). The discharge in the first 2–3 days after childbirth looks like bright red blood, from the 3–4th day until the end of the first week it is paler, sanious, and then the lochia brighten even more, acquire a yellowish tint, become mucous. On the 5-6th week of the postpartum period, spotting stops completely and has the same character as before pregnancy.

during this period helps the doctor to objectively assess the condition of the organs reproductive system women after childbirth and, if necessary, to timely treatment any complications.

After natural childbirth

During the early postpartum period (that is, in the first 2 hours after birth), ultrasound is used for suspected uterine rupture and for heavy bleeding to diagnose their causes.

In the normal course of the postpartum periodUltrasound of the uterusmost often carried out on the 2-3rd day after childbirth. The transabdominal method is usually used (examination of organs through the anterior abdominal wall). This choice is explained by the fact that the uterus is still quite large in size, and it is difficult to examine it completely with a vaginal probe. In some situations, if a more detailed examination of the cervix is ​​necessary, the vaginal ultrasound diagnostic method is also used.

One of the important criteria to be assessed is the condition of the uterine cavity. Normally, it is slit-like or slightly expanded due to the presence of a small amount liquid blood or blood clots, which at this time may be in its upper part, and by the 5-7th day they are shifted to the lower sections. An ultrasound doctor can see a change in the uterine cavity - its excessive expansion, the presence of fetal membranes in it, the remains of placental tissue, excessive accumulation of liquid blood or its clots, all this helps to prevent serious complications of the postpartum period. The size of the uterus is also estimated, and then they are compared with the normative tables developed for the normal course of the postpartum period.

Complications after childbirth

Subinvolution of the uterus . Sometimes, when examining a patient, the doctor notes that the size of the uterus exceeds due. It could be physiological state, for example, after multiple pregnancy, childbirth with a large fetus, polyhydramnios, in multiparous women. In other cases, such a discrepancy is considered pathological and is called subinvolution of the uterus, i.e. slowing down its development. In situations like thisallows you to identify the cause of the deviation from the norm and helps the obstetrician-gynecologist determine further tactics of action. This complication occurs in about 1.5% of women who have given birth.

With insufficient contraction of the uterus during the first 5 days, the condition of the woman is observed and carried out drug treatment- prescribe drugs that reduce the uterus, as well as antispasmodics that relax the muscles of the cervix to ensure a full outflow of contents. If ultrasound in the uterine cavity is determined a large number of large blood clots, it may be necessary to vacuum aspirate (remove blood clots using vacuum suction) or curettage of the uterine cavity. If they are not removed in a timely manner, an infection from the vagina can enter the uterus and develop severe complication postpartum period - endometritis (inflammation of the inner lining of the uterus). Therefore, timelycan significantly reduce the risk of developing this disease.

Postpartum endometritis . Ultrasound signs of endometritis are a decrease in uterine tone, expansion of the cavity, accumulation of gas in it, remnants of placental tissue or fetal membranes. It is important to understand that the treatment of endometritis must be started as early as possible. The woman is assigned bed rest, a course of antibiotics and uterine contractions. If treatment is not started on time, endometritis turns into severe form, which may require removal of the uterus and even threaten the woman's life. But it is important to note that this disease is quite rare - in about 2% of women after childbirth through the natural birth canal.

Postpartum bleeding. Ultrasound on the 2-3rd day after childbirth can prevent very formidable complications of the postpartum period - bleeding, which can begin suddenly and are very plentiful. Often they are caused by remnants of placental tissue or membranes in the uterine cavity, which is easily diagnosed by ultrasound. In such cases, to stop bleeding, it is necessary to scrape and remove the remnants of placental tissue.

If at the first any pathology is detected, ultrasound is done several more times during and after treatment in order to evaluate the effectiveness of therapy. And only in case good results control study, a young mother can be discharged home under the supervision of a doctor antenatal clinic.

After caesarean section

After caesarean section the uterus returns to its size more slowly than after vaginal delivery. This is due to the violation of the structure muscle fibers the walls of the uterus due to the incision made during the operation. It takes the size and shape as before pregnancy only by the 10th day of the postpartum period.

After a caesarean section, a woman in labor has a significantly increased risk various complications- postpartum endometritis occurs more often and is more severe (6-11% of cases), the frequency of bleeding is higher (about 5%), both external - from the vagina, and internal - into the abdominal cavity. Therefore, ultrasound examination plays an invaluable role in the observation of such young mothers.

In most cases, an ultrasound examination of the organs of the reproductive system is performed for women in labor on the 3rd–4th day after surgery. Butmay also be prescribed within a few hours after the end of the operation to exclude bleeding into the abdominal cavity and violation of the integrity of the sutures on the uterus. A study is carried out if a woman complains of intense abdominal pain or with unsuccessful blood tests, in particular, with a decrease in hemoglobin levels after surgery.

Ultrasound diagnostics after caesarean section can be performed with both transabdominal and vaginal sensors.

With the help of ultrasound, the same parameters are evaluated as after natural childbirth. But, in addition to this, a mandatory inspection is also carried out. postoperative scar on the uterus. Often, deviations in his condition indicate the development of certain complications. So, for example, a specific ultrasound sign of a developing postpartum endometritis after caesarean section is swelling of the sutures on the uterus.

Unfortunately, the healing of sutures after the operation is not always successful. In these cases, ultrasound helps to diagnose hematomas (blood accumulations) in the scar area, monitor their size and location, and, based on this, choose a treatment method.

When any pathology is detected, control ultrasound examinations are carried out repeatedly, assessing the state in dynamics. After reaching positive results treatment, a young mother is discharged home under the supervision of a antenatal clinic doctor.

V without fail with ultrasound in women after childbirth (natural and after cesarean section), the condition of the ovaries, the presence of fluid and blood clots in abdominal cavity, in the pelvis, which are normally absent, as well as the state of the veins of the uterus and the surrounding tissue.

After discharge from the hospital

If for some reason an ultrasound scan was not done before discharge from the hospital, then it is necessary to visit the gynecologist of the antenatal clinic within the first week after returning home and decide on the need for this study.

All puerperas included in the group high risk development postpartum complications, and anyone with complications immediately postpartum is strongly advised to repeat uterine ultrasound 5 to 8 days after discharge from the hospital. Research carried out during this period will help prevent late complications or their repetitions. The risk group includes women with multiple pregnancies, polyhydramnios, prolonged labor, large blood loss during childbirth, a long interval between the outflow of amniotic fluid and the birth of a baby, manual separation of the placenta.

However, even if everything was in order during the ultrasound in the maternity hospital and nothing bothered the woman at discharge, it must be remembered that in late dates postpartum complications may occur. Therefore, a young mother is advised to contact a gynecologist about a month after giving birth, and at the appointment the doctor will determine the need for an ultrasound scan. If no abnormalities are found, then the next visit to the doctor and preventive ultrasound should be scheduled after about 6 months.

Indications for ultrasound

Indications for urgent medical attention and pelvic ultrasound are increased spotting from the genital tract, which may indicate a delay in the uterine cavity of the placenta - the so-called placental polyp(an outgrowth on the wall of the uterus from placental tissue).

Usually, the polyp is clearly visible on ultrasound. In this case, it is necessary to carry out curettage of the uterine cavity.

Also, a young mother should be alerted by an increase in body temperature, changes in the nature of the discharge - the appearance of lochia with an unpleasant odor, purulent. Similar symptoms may indicate the development of postpartum endometritis.

Worthy of close attention are pain in the lower abdomen, in the area of ​​​​the seam after a cesarean section and the appearance of discharge from it. Such manifestations can be observed with the inferiority of the suture, its divergence, which may require additional surgical treatment.

The site is a medical portal for online consultations of pediatric and adult doctors of all specialties. You can ask a question about "ultrasound after caesarean section" and get free online consultation doctor.

Ask your question

Questions and answers on: ultrasound suture after caesarean section

2014-10-10 06:46:00

Svetlana asks:

After exercise(rocked the press) yesterday I felt pain in the area of ​​​​the seam after a cesarean section (transverse seam). Seam is 27 years old. And today they just slashed me like a knife, also after the exercise. I can't bend over or bend over. I thought the inside seam had come apart. What can be, on ultrasound can show the reason?

Responsible Bosyak Yulia Vasilievna:

Good afternoon, Svetlana! In this situation, it is necessary to really undergo an ultrasound scan of the pelvic organs and consult a specialist with a conclusion. Be healthy!

2015-02-21 20:50:18

Maria asks:

I've had three cesareans. The last one was 11 months ago. I recently made an ultrasound diagnosis (thinning of the myometrium in the area of ​​the scar after cesarean section, adenomyosis and adhesions of the peritoneum of the small pelvis), the scar on the uterus is thinned to 1.9 mm, under thinning the uterine cavity is expanded to 6.3 mm over 5.8 mm. There are pains in the abdomen in the area of ​​the seam. The question is can the seam break? And what does it mean? Our gynecologists said that there is nothing to worry about.

2012-01-22 22:27:19

Ela asks:

Hello, I have a problem after a cesarean section. On the third day after the operation, the temperature jumped a lot, we could not determine the cause for a long time, it turned out that a hematoma formed inside, which was opened. Three years passed, a 13 mm thickening formed just above the postoperative suture, localization of pain in one place (at the site of compaction) during menstruation, especially. They didn’t really say anything by ultrasound, in this place the doctor noted a reduced echogenic zone. What is the likelihood of endometriosis of the scar or keloid? Which additional examination it is necessary to pass or take place (I am afraid of inevitability of a laparoscopy)?

Responsible Wild Nadezhda Ivanovna:

You may indeed have endometriosis. For diagnosis, observation, ultrasound in dynamics is necessary. Stop the progression of endometriosis. Combined oral contraceptives(COCs). It is necessary to do an ultrasound immediately after menstruation and on the eve of menstruation. And it will be possible to say whether there is endometriosis or not.

2012-12-03 17:07:29

Periwinkle asks:

Hello, I had a caesarean section, the operation was successful, a healthy girl was born. In the hospital, before being discharged, they didn’t examine me on the chair, they didn’t do ultrasound, they didn’t take blood, they said that there was no evidence. A day after discharge, aches began in the whole body, then the temperature rose to 38.3 degrees. solution, oxytocin, cefazolin 2 gr. intravenously. My question is the following, was it possible to determine earlier the closure of the cervix in a hospital setting? I had discharge after the operation for only 3 days, but the doctors did not ask me about the discharge, they only looked at the suture and touched my stomach.

Responsible Wild Nadezhda Ivanovna:

According to the new orders, the examination on the armchair is carried out strictly according to indications. It is not possible to predict how sh / m will behave. It has great importance the frequency of feeding the child. The more often you feed, the better the uterus contracts and pushes the lochia out of the uterus.

2012-03-09 20:08:22

Svetlana asks:

I'm 43 had three births and 6 abortions as well ectopic pregnancy last birth 5 years ago, now I’m pregnant with my husband, I’m going to give birth, tell me if I can ask a doctor for a planned cesarean because I’m afraid to give birth at this age, my mother gave birth at 41, the child died during childbirth, I don’t complain about health, but in the previous pregnancy 5 years ago there was atrial tachycardia 156ud did an ultrasound of the heart in the myocardium, there were changes, but the birth passed more or less, except for the fact that the cervix was opened manually, since after the ectopic it opened weakly and one-sidedly from the side of the seam, I don’t want to risk myself or the child, is a caesarean section possible in my case, thanks for the answer

Responsible Medical consultant of the portal "site":

Hello Svetlana! You can ask your doctor for a planned caesarean delivery, but think about this. Cesarean section is an abdominal operation, with the use of anesthesia or epidural anesthesia, a large load on the woman's body, the risk of various complications (bleeding, infection), relatively severe postoperative period. Pre-existing cardiac problems can affect the course of the operation to a much greater extent than the course of a natural birth. In addition, you have already given birth to a woman three times - the fourth birth should not present any particular difficulty or problem for you. Therefore, asking for an operation for you is not quite the right decision. Discuss the situation with your doctor, with your husband, think for yourself (well) - and you will understand that natural childbirth in the absence of indications for a caesarean section is the best option for you. Take care of your health!

2011-10-23 17:01:29

Olga asks:

Hello! I really need your advice ... the fact is that now I am in a position, 28 weeks pregnant. second pregnancy, the first pregnancy was almost 4 years ago in March 2008. it ended with an emergency caesarean section (I was pierced with a bladder, although there were no contractions, after that the contractions began, they were all night, in the morning they told me that the child did not descend, I needed to be caesarean, because for a long time to be without water ... everything is with the child I'm fine, 4160kg, but I lost a lot of blood during the operation, I felt very bad... the thought that I will have to go through all this again just haunts me.My dream is to give birth on my own, but in our small town, doctors over my desire laugh, calm down, and get ready for a cesarean! natural childbirth after CAESAREV, please answer, I beg you, can I think about natural childbirth? seam is vertical. maybe you need to send some tests? or ultrasound results. so you can at least guess if there is a chance for me !? you are my hope PLEASE ADVISE WHAT I SHOULD DO???!!! THANK YOU SO MUCH IN ADVANCE FOR YOUR ATTENTION AND UNDERSTANDING! VERY WAITING FOR ANSWER... OLGA, 24 years old, Republic of Sakha (Yakutia), Lensk

Responsible Tovstolytkina Natalia Petrovna:

Hello Olga. Now quite often after a caesarean section, vaginal births are performed. At the same time, there are clear contraindications for such childbirth, one of them is the failure of the scar on the uterus, which can be reliably determined in the first stage of childbirth. In addition, if you again have a large child (more than 4 kg), then there is a very high probability of rupture of the uterus along the old scar during vaginal delivery. I think that your uterus was cut transversely, only the skin was sewn up with a vertical suture, otherwise vaginal delivery is contraindicated. If there are also no other indications for a caesarean section (which may be in a normal pregnancy), then you can try to give birth yourself. Good luck.

2011-02-09 11:43:17

Svetlana asks:

Hello! I am 35 years old. In 2002 I had my first child. They did a caesarean section, arguing that I have narrow pelvis and a large fruit (3800). The recovery seemed to go well. In 2009 I got pregnant again, the doctors were set only for the operation. The pregnancy proceeded normally, under the constant supervision of a doctor. handed over necessary tests on time for an ultrasound. During the operation, problems began. Firstly, anesthesia had a bad effect on me, I “woke up” several times, so to speak, heard the doctor’s voice, his nervousness. Then the bleeding started. The placenta was attached to the anterior wall of the uterus, and the doctor could not tear it off. The operation lasted over two hours. As the doctor later told me, she already wanted to remove everything for me, as new foci constantly appeared. She got a lot of stitches. After this operation, I recovered within six months. And despite all the difficulties experienced, my husband and I would like to have another baby. Please tell me if this is possible? Where do we start? Thank you

Postpartum complications occur most often in the first days after childbirth. Manual obstetric examination does not always give a complete picture of a woman's condition. Therefore, in maternity hospitals, they resort to the method of ultrasound examination of the puerperal before discharge. Ultrasound helps to diagnose various pathologies postpartum period.

About how ultrasound is done after childbirth, and what problems the procedure reveals, read in this article.

An ultrasound examination of the internal genital organs is performed for each woman who has given birth 3-4 days after childbirth, before discharge from the hospital. During the procedure, the doctor checks the condition of the uterus, ovaries and cervix through the anterior abdominal wall. Ultrasound through the vagina in the first days after childbirth is not used due to large sizes uterus. With the help of a transvaginal sensor, it is difficult to thoroughly examine all departments of this organ.

After childbirth, the uterus gradually returns to its pre-pregnancy state. This process is called involution. The doctor of ultrasound diagnostics determines the condition of the woman's internal genital organs and gives permission for discharge from postpartum ward. It is important to take into account such indicators:

• Do the dimensions of the birth canal correspond to the norms.
• Whether there are blood clots and in what volume.
• How does the placental site heal.
• Is the structure uniform? inner surface uterus.
• What is the condition of the uterine veins.
• If there was a caesarean section, then the doctor checks the condition of the seam.

Normal indicators of the state of the uterus after childbirth

If the birth went without complications, then the involution of the birth canal takes place at a normal pace.

Ultrasound on the 3-4th day after childbirth reveals blood clots in a small amount in upper divisions uterus. After 7-8 days, they descend closer to the exit from the organ cavity. Immediately after childbirth, the uterus resembles a ball in shape, after 3 days - an oval, after 7 days it takes a pear-shaped shape. Restores muscle tone pelvic floor. They gradually shift the uterus to its previous location. Immediately after childbirth, the bottom of the uterus is located 4 cm below the navel, a week later - in the middle of the distance between pubic bone and belly button.

The weight of the uterus is also determined by ultrasound. Immediately after giving birth, she weighs 900-1000 grams. A week later - 500-600 gr. After 2 weeks already 350 gr. By the end of the postpartum period, after 5-7 weeks, it returns to its previous volume - 60-70 g.

By the end of the postpartum period, the uterus returns to pre-pregnancy size.

What Problems Does Ultrasound Detect?

With the help of an ultrasound examination, the doctor can diagnose postpartum complications in time:

Ultrasound after childbirth helps to determine the rate of uterine involution in time, and as a result of postpartum complications. If the contractions are weak, the doctor will prescribe drugs that will make her contract more actively.

Ultrasound after caesarean section

After a caesarean section, involution is slower. The uterus contracts weakly, postpartum discharge goes badly. Because of this, the risk of developing endometritis increases. In addition, pain after abdominal surgery often mask inflammation in the uterine cavity.

During ultrasound, the doctor checks the condition of the postoperative suture: its stability, thickness, and whether there is inflammation of nearby tissues.

After 1.5-2 years after cesarean section, you need to check the condition of the seam. You can only get pregnant again if the scar is completely healed.

Indications for urgent ultrasound

In some cases recovery period drags on. This is due to the occurrence of postpartum complications. If, after being discharged from maternity hospital a woman is concerned about changes in the nature of discharge or pain, it is worth consulting a doctor. Indications for ultrasound may be the following symptoms:

• The seam hurts after a cesarean section or an ichor is released from it.
• Failure of the postoperative suture or inflammation of the tissues around it.
• The discharge suddenly increased and has an unpleasant odor. This is indicative of endometritis.
• The woman's body temperature has risen. The inflammatory process is accompanied by an increase in body temperature.
• Bleeding began, the suckers sharply became intense. The cause may be a placental polyp. This pathology is a proliferation of the mucous membrane at the site of attachment of the placenta.

It is often possible to establish the cause of the pathology only by ultrasound. Therefore, if these symptoms appear, you should definitely consult a doctor.

If childbirth and the early postpartum period passed without complications, and the first ultrasound showed that the uterus is recovering normally, then the woman needs to visit a gynecologist after the end of lochia. And after examination, if necessary, do an ultrasound.

Ultrasound in the postpartum period can be performed as often as necessary. Ultrasonic waves do not harm a woman's health.

During the perinatal period reproductive system women undergo a certain biological transformation. The return of internal organs to an adequate state takes an average of one and a half months. To control this process, a mandatory ultrasound procedure after childbirth is provided. The largest number complications are recorded in the first postpartum week. Ultrasound is the only highly informative and accessible method for the diagnosis of distorted manifestations of the reproductive system during the recovery of a woman after childbirth.

Changes in the uterus in the postpartum period

After natural delivery, with a short time interval, the placenta with the membranes of the fetus (afterbirth) is “born”, the uterus begins to contract vigorously. These contractions cause acute pain lower abdomen. The organ works in an active mode, on the 5-7th day the uterus contracts three times, by the 10th day - ten times, that is, it takes on dimensions corresponding to the state before pregnancy. At the same time, the uterus is shifted to the place of its anatomical location. Shape changed during pregnancy reproductive organ(spherical uterus), returns to natural pear-shaped within a week.

The contraction time increases in the following cases:

• carrying out an operation for artificial delivery (caesarean section);
• multiembryonic pregnancy;
• artificial feeding (a woman does not release the hormone oxytocin, which stimulates contractile activity);
• excess amniotic fluid (polyhydramnios);
• trauma during childbirth;
• coagulation disorders ( poor clotting blood).

These reasons require heightened attention from the gynecologist. Low contractile activity uterus can lead to serious postpartum complications, in particular: inflammation of the lining of the intrauterine layer (endometritis), uterine bleeding, outflow disturbance postpartum discharge(lochia), bending of the reproductive organ, formation of a barrier in the vagina, due to the accumulation of postpartum clots. The task of doctors is to prevent unwanted complications, or fix them at the initial stage, which is why they do ultrasound after childbirth.

Normal transformation of the uterus after childbirth

Control procedure

A standard postpartum ultrasound examination is performed 2–4 days after the date of delivery. In case of unnatural delivery (cesarean), the doctor prescribes the timing of the procedure on an individual basis. Urgent ultrasound should be done when a woman has the following symptoms:

• copious separation of clots;
• intense outflow of blood from the vagina;
• febrile or pyretic body temperature (38-41 ° C);
• unbearable pain in the internal organs;
• soreness, swelling, wetting of the postoperative suture (in case of caesarean section).

According to the results of ultrasound diagnostics, conservative therapy or emergency surgical intervention to eliminate the complications that have arisen. The control ultrasound is carried out in the hospital and only after that the woman is discharged home. A re-examination should be done in a week.

Preparation and holding

Since the process of childbirth is already over and there is no amniotic fluid, it is necessary to fill the uterus before the study to visualize bladder. The amount of liquid drunk should be at least two liters. In the case of an urgent procedure, fluid is injected through a catheter, followed by diuretic medication.

After childbirth, ultrasound is usually performed by the abdominal, that is, external method. Transvaginal (internal) examination is informative only when examining the cervix. The organ itself is still too voluminous, so the intravaginal sensor will not give an objective result. The time interval of the procedure is from 20 to 40 minutes, depending on the health of the reproductive system.

Study parameters

Postpartum examination of the organs of the patient's reproductive system is aimed at identifying possible pathologies leading to complications. The assessment is made according to the following parameters:

• contractility, location and size of the uterus;
• the presence of organic formations (pieces of "children's place", blood clots, fragments of the fetal membrane);
• the presence of excess fluid in the uterine cavity;
• possible inflammatory processes of the endometrium;
• condition of the postoperative suture (if a caesarean section was performed);
• general condition of the pelvic organs.

The indicators obtained during ultrasound diagnostics are compared with average standards. In case of discrepancy between values, the patient is assigned special treatment. With an uncomplicated postpartum period, it is recommended to visit a gynecologist in a month. At the appointment, the doctor will determine the need for monitoring through ultrasound.

Changes in the uterus: immediately after delivery, after a week, after 5 weeks

Normative indicators of the reproductive system in the postpartum period

Features of the restoration of internal genital organs depend on the method of delivery ( naturally or by caesarean section).

Rehabilitation after natural childbirth

After the natural birth of the baby, the ultrasound examination procedure is prescribed from the second to the fourth day. In the case of complicated childbirth, if uterine rupture is suspected, ultrasound is done immediately. On longitudinal examination, the uterus has an elliptical shape. The organ is located in the middle part of the small pelvis. Some downward displacement is observed after the birth of two or more children or one large baby.

On the study, you can track the dynamics of reducing the mass of the uterus and narrowing the size. The decrease in the volume of the uterus and its movement to the natural location takes place gradually. The advance rate is 1-2 cm daily. In terms of weight, the organ loses about half of its mass (400–500 grams) in the first week. Further, weight loss occurs smoothly, approximately 100 g per week, to the original 90-100 grams. The main indicators that the doctor measures on the monitor during the study relate to the uterus itself and the uterine cavity.

Average digital values ​​of parameters

Ultrasound diagnostics after caesarean section

Rehabilitation of the reproductive system after cesarean lasts longer, since the weight and size of the uterus after surgical intervention increase, on average, by 40% compared to natural labor activity. During the ultrasound, the doctor can observe small hematomas in the area of ​​the postoperative scar. They are not dangerous, but they impede the passage of ultrasonic waves. Swelling of the scar may indicate the onset inflammatory process in the endometrium.

Optimal condition of the postoperative scar

The uterus decreases by 200-250 grams in the first seven days. The organ returns to its original mass parameters after about eight weeks. In form, it takes on its original form no earlier than 10-12 days. The main measurement parameters (length, width, anterior-posterior size) also lag behind in terms of natural childbirth. After operative delivery, a more thorough ultrasound diagnostics ovaries and blood vessels to make sure they are in perfect condition.

The control ultrasound procedure is prescribed individually, depending on the results obtained.

Possible Complications

Ultrasound after childbirth helps to identify a number of problems that, if not addressed in time, can lead to serious complications. To the most frequent pathologies that ultrasound shows include:

• The concentration of organic clots. The clots formed in the uterine cavity consist of coagulated blood, fragments of the fetal membrane, particles of the "children's place". The accumulation of organic fragments prevents the outflow of postpartum secretions, and can provoke inflammation or latent (low-intensity bleeding). To eliminate the problem, a woman is assigned a vacuum aspiration.
• Weak contractile activity or subinvolution of the uterus. Such a diagnosis is made in the case when the indicative parameters of the uterus do not fit into standard values. Appointment helps to correct the process special medicines to reduce smooth muscles in parallel with antispasmodics that improve the outflow of lohani.
• Inflammation of the intrauterine mucosa (endometritis). The cause of the disease is most often bacterial infection. Pathogens enter the uterine structures from lower divisions reproductive system, in case of prenatal violation of the microflora of the vagina.

In addition, endometritis lead to:

• delayed rupture of the fetal membranes;
• inflammation of the outer and inner membranes of the fetus, which appears during pregnancy and childbirth (chorioamnionitis);
• intervention in the delivery process (caesarean section or manual separation"children's place");
• excessive blood loss during childbirth;
• improperly performed childbirth.

The last item includes injuries to the perineum or genital organs received by a woman during childbirth. Indicated for endometritis antibiotic therapy, bed rest, diet food. In complicated cases, the woman remains on inpatient treatment in the department of gynecology.

Compared with physiological childbirth, the frequency of postpartum complications after a planned caesarean section increases by 4-5 times, after an emergency - by 6-7 times

After discharge

The woman is re-examined at the place of residence, in accordance with the planned period. Indications for emergency diagnosis are:

• plentiful vaginal discharge with a pungent odor;
• bleeding;
• pain in the pelvis (often accompanied by a disorder of urination and stool);
• suppuration and swelling of the scar after caesarean section;
• prolonged hyperthermia, not associated with colds.

If, for any reason, an ultrasound examination was not performed during the stay in maternity ward, you need to do it yourself, regardless of the presence of alarming symptoms.