Is an ultrasound necessary after childbirth? An important diagnostic examination of the mother is ultrasound after childbirth: all the details of the procedure and the values ​​​​of the indicators.

All pregnant women regularly visit the gynecologist and do ultrasound in a timely manner. However, few people think about the need for an ultrasound examination of the organs of the reproductive system after childbirth. With the help of ultrasound, all the main characteristics of female reproductive organs, compliance with their standards for a particular period. This information is essential to prevent possible postpartum complications.

Involutive processes in the organs of the reproductive system

The first six weeks after the birth of a child, involutive processes take place in a woman's body: organs and systems that have undergone changes during pregnancy gradually return to normal, to their natural state.

Immediately after childbirth, the uterus begins to decrease intensively, and there is a noticeable change in its shape. Already on the 10th day, she acquires her natural parameters that were before pregnancy. If by the end of pregnancy the weight of the uterus is about 1 kg, then already on the 7th day after birth, its weight is about 0.3 kg, and the norm of this indicator is 0.1 kg.

A significant characteristic is the shape of the uterus. On the 3rd day after birth, it retains a spherical shape, on the 5th day it takes the form of an oval, and on the 7th day it becomes pear-shaped, i.e. corresponds to the norm.

There is a change in the vaginal discharge. At first, the discharge is bright red, then gradually brightens and by 5-6 weeks becomes the same as before conception.

Ultrasound after natural delivery

An indication for ultrasound in the first two hours after delivery is the threat of uterine rupture and suspicion of bleeding.

In the case of the course of the postpartum period without complications, an ultrasound examination is prescribed on the 3rd day. Basically, ultrasound is performed through skin covering lower abdomen, i.e. use transabdominal research technique. The choice of the ultrasound method is due to the fact that the size of the uterus has not yet returned to normal, and it is difficult to conduct a study using a vaginal sensor.

Ultrasound after childbirth provides an opportunity to get important information about the state of the reproductive system of the woman in labor, timely identify the deviation of the main indicators from the norm and avoid complications.

First of all, with the help of ultrasound, the uterine cavity is examined. The norm at the same time is a slit-like form and its insignificant expansion due to the remnants of blood clots in it, which should move down into the vagina on the 5-6th day. Ultrasound diagnostics allows you to detect its abnormal increase, fetal membranes and placental tissues, pathological amount of blood.

The contraction of the uterus is judged by the height of its bottom. Height decreases after childbirth every day by 2 cm. Immediately after delivery, muscles pelvic floor and the vaginas are restored and begin to displace the uterus. So, on the second day, the uterine fundus is located 13-14 cm higher than the pubic junction, on the 6th day - 8 cm, on the 10th - the uterus is practically at the level of the pubis, and after 5 weeks it reaches his normal state.

Violation of the processes of reverse development of the uterus

Sometimes there is a discrepancy between the sizes of the norm. This condition can be explained physiologically. So, pregnancy with two or more fetuses, a child larger than 3.5 kg., As well as polyhydramnios are often accompanied by strong increase uterus. Other variants of this condition are considered pathological. This pathology is called - uterine subinvolution. This pathology is observed in 2% of women in labor.

If the ultrasound indicates a large volume blood clots, they prescribe a procedure called vacuum - aspiration, that is, the removal of blood clots using a vacuum pump, or curettage is performed.

Postpartum endometritis

Untimely removal of excessive contents of the uterus can lead to the development of a serious disease - endometritis. An infection enters the uterine cavity from the vagina and causes inflammatory processes on the inner shells. The ultrasound technique can significantly reduce the likelihood of this complication. Without adequate treatment the disease is complicated, a severe form of endometritis develops. However, it is worth noting that such a complication of childbirth is quite rare, no more than 2% of women in labor who have had childbirth suffer from it. naturally.

Also, using the ultrasound technique, it is possible to prevent a number of complications, including sudden bleeding in the first days after delivery. In the event of the onset of bleeding, urgent curettage is prescribed.

Ultrasound after caesarean section

Body recovery after caesarean section longer and more difficult than after a natural delivery. The incision made during the operation violates the structure muscle tissue causing the uterus to contract slowly. The size and shape of the organ are normalized only by the end of the second week of the postpartum period. The healing of the suture from the caesarean section and the formation of the scar is quite long.

Conducting a caesarean section significantly increases the likelihood of postpartum complications. In the observation of women with caesarean section, the role of ultrasound is difficult to overestimate.

Usually, ultrasound of the pelvic organs after childbirth is done on the 3rd day after cesarean section. The study is sometimes carried out on the day of surgery in order to confirm the integrity of the suture. Unscheduled ultrasound diagnostics is carried out with intense pain in the suture area.

Ultrasound is used to further assess the condition postoperative suture on the uterus. The existence of special hardware techniques for applying ligatures allows you to accelerate healing uterine walls and improve the condition postoperative scar. Often the deviation of the parameters of the scar from the norm is an indicator of development pathological processes. So, swelling of the scar may indicate the onset of endometritis.

Recovery of the body after cesarean section and healing of the suture does not always proceed without complications. Ultrasound allows you to determine the presence of hemorrhages in the area of ​​the scar, track their location and size. Based on these data on the state of the seam, the most suitable technique treatment.

It is believed that the complete healing of the scar occurs two years after the operation. And repeated pregnancy you can only schedule at this time or later. Before the next conception, it is advisable to do a control study of the scar.

Ultrasound after discharge from the maternity hospital

On the 7-10th day after discharge, it is recommended to visit the local gynecologist and decide whether there is a need for an ultrasound scan and when it is better to undergo this study. If the young mother does not have any complaints and deviations in all respects, then the next visit to the doctor is recommended in six months.

An absolute indication for ultrasound after discharge is the presence of complications in the early postpartum period and complications of caesarean section. During the ultrasound of all women in labor in early period after childbirth, it is necessary to diagnose the condition of the ovaries, uterine veins. They also determine the abnormal presence in the pelvic cavity of fluid and blood clots, placental remnants, and also examine the condition of the scar after cesarean.

Alarming symptoms and reason for an ultrasound

One of anxiety symptoms- this is an increase in the amount of vaginal discharge, a change in color. These signs may indicate the presence placental polyp.

In the case when there are pains in the area of ​​​​the seam from a caesarean section, and even more so discharge from it, this indicates the pathology of the scar, its possible divergence.

So, yesterday we started talking about what happens to a woman in the postpartum period and how it is possible to identify on ultrasound with the help of an ultrasound examination. early stages health problems and the formation of serious postpartum complications. This helps at the initial stage to carry out active treatment, which will allow a woman to maintain childbearing functions and not earn herself chronic pathologies for life. So, what can experts see on an ultrasound examination? maternity hospital or women's consultation in the postpartum period?

Formation postpartum endometritis

Postpartum endometritis is called inflammation of the endometrium of the uterus (its inner mucosa). When conducting an ultrasound examination, the main signs of endometritis may be a decrease in the tone of the uterus and a fairly pronounced expansion of its cavity, the accumulation of gases in the uterine cavity, the presence of remnants of placental tissues or fragments of membranes in it. It is important for you to understand that you need to start treatment as early as possible so that you can spend as little time in the hospital as possible, and you can be discharged home with your child faster. Women with endometritis are prescribed strict bed rest to reduce the spread of inflammation, an active course of antibiotics (usually injected intramuscularly) and drugs to speed up the contraction of the uterus are required. If treatment is not started immediately after the diagnosis is established, endometritis can go into a very severe stage, which may even require surgery to remove the uterus and can really threaten the life and health of a woman who has recently given birth. However, in fairness it should be noted that today this pathology is due to timely diagnosis and prevention is rare, in about 2% of women who give birth vaginally.

Formation postpartum hemorrhage

Postpartum hemorrhage can be a serious complication of natural or operative childbirth. Conducting an ultrasound examination on the second or third day from the moment of birth will prevent such formidable complications in the postpartum period. Bleeding can start suddenly and can be very heavy at times. Often, the causes of incipient bleeding can be the remnants of placental tissues remaining in the uterine cavity, the remnants of the fetal membranes inside the uterine cavity, and this is easily diagnosed during ultrasound control after childbirth. In such cases, in order to stop the bleeding, it is necessary to carry out therapeutic curettage inside the uterine cavity and promptly remove the remains of placental tissues. If any pathologies were found during the initial ultrasound examination in the postpartum period, then the study is carried out with the regularity necessary to track the dynamics of the process and evaluate the effectiveness of the measures taken. In case of positive dynamics and good results control ultrasound, a young mother with a baby is discharged from the maternity hospital under the supervision of antenatal clinic doctors. But in case of the slightest doubt, the doctor will immediately send the woman to the gynecological hospital.

After a caesarean section

The caesarean section is special kind surgery on the genitals, which allows the birth of a child. And like any operation, this one is also not performed just like that, without indications, for its implementation it is necessary to have certain indications- relative or absolute. And after a caesarean section, the uterus will return to its previous size much more slowly than the same process occurs during natural childbirth. The reason for this is the violation of the structure muscle fiber in the area of ​​the uterine wall due to an incision and subsequent suturing, which gives the formation of a scar on the uterus. The size and shape of the uterus, as it was before pregnancy, the uterus, when performing a caesarean section, acquires only on the 10th day of the postpartum period.

In addition, performing a caesarean section in a woman in labor in itself quite seriously increases the risks different kind complications. More often there are phenomena of endometritis after childbirth, the frequency of bleeding increases, and they can be external, blood is poured from the vagina, and internal bleeding with accumulation of blood in abdominal cavity. That is why ultrasound research methods, as the simplest and most non-traumatic, play a leading role in monitoring young mothers who have given birth operatively.

Usually, an ultrasound examination in the area of ​​\u200b\u200bthe uterus and reproductive organs of a woman who has given birth to a child by caesarean section is prescribed from the third to the fourth day after the operation. But sometimes, in some cases, according to the doctor's prescription, ultrasound examinations can be prescribed during the first few hours after the operation in order to exclude bleeding in the abdominal cavity or violation of the integrity of the suture on the uterus, its ruptures or other problems. The study should be carried out in the presence of typical complaints of women, especially with indication of abdominal pain, in the presence of bad tests blood, especially sharp decline hemoglobin and hematocrit after surgery. An ultrasound examination can be carried out both through the anterior abdominal wall(transabdominally), and through the vagina with a vaginal probe.

On ultrasound, approximately the same parameters are evaluated as in conventional natural childbirth, but in addition, mandatory research scar in the uterus. Often, it is the condition of the scar that will be evidence of certain pathologies, for example, an ultrasound sign of postpartum endometritis during caesarean section is swelling of the uterine sutures. The healing of sutures during cesarean section does not always go smoothly, in such cases, ultrasound helps in the diagnosis of hematomas (blood accumulations) in the area of ​​​​the surgical scar, and also helps in monitoring the size and size, location of hematomas, determines the choice of treatment method.

Ultrasound for control in case of identified pathology is carried out repeatedly, as prescribed by a doctor to assess the dynamics of the process and the effectiveness of treatment. With positive dynamics and no danger to the woman's health, she is discharged home from the maternity hospital under the supervision of a antenatal clinic doctor. It is imperative that when conducting an ultrasound scan of a woman after childbirth, whether it is natural childbirth or a cesarean section, they assess the condition of the ovaries, and also check for the presence of fluid or blood clots in the abdominal cavity, in the pelvic area - in normal conditions they must be absent. In addition, it is important to assess the condition of the uterine veins and the surrounding tissue.

After leaving the hospital

If you did not have an ultrasound scan for any reason while still in the maternity hospital, it is necessary in without fail spend in the antenatal clinic along with a visit to the gynecologist during the first week after discharge from the hospital home. It is also important to decide on the need for an ultrasound if this study was conducted in the maternity hospital and there were any manipulations or therapeutic actions. So, all women who are at risk for the formation of postpartum complications, as well as those who had complications in childbirth, must undergo an ultrasound of the uterus five to eight days after discharge from the hospital. Ultrasound in these terms will help in preventing late complications or recurrence of endometritis. The risk group is multiple pregnancy and polyhydramnios, prolonged labor and blood loss during childbirth, a long anhydrous interval, manual control over the separation of the placenta.

If, according to the results of ultrasound in the maternity hospital, everything was fine, this does not exclude the formation of late complications of the ear at home, a mandatory visit to the doctor and an ultrasound scan for control after discharge from the maternity hospital are necessary. It is imperative to go to the gynecologist in the first month after childbirth, and the examination doctor will determine the need for an ultrasound scan, if no deviations are found - the next visit to the doctor awaits you six months after the birth.

To whom and when is an ultrasound indicated?

Indications for immediate ultrasound after childbirth can be:

Increased blood flow from the genital tract, which may indicate the presence of placental remnants in the uterine cavity, a placental polyp, which is clearly visible on ultrasound and is an indication for curettage of the uterine cavity;
- fever, change in discharge, the appearance of an unpleasant odor, an increase in the volume of lochia, the appearance of blood after it has already stopped, which may indicate bleeding or infection. This requires the start of immediate treatment;
- painful and discomfort in the lower abdomen, in the area of ​​​​the scar from a caesarean section, which may indicate the failure of the suture or its divergence.

After childbirth, a woman thinks only about the newborn, not paying attention to her condition. The employees of the maternity hospital are worried about the woman in labor. A woman does not even think about when to do an ultrasound. Experienced professionals decide for her.

When it is better to do ultrasound diagnostics in the postpartum period, doctors determine depending on the course of the baby's birth process, the patient's well-being, the type of birth (natural, caesarean section).

Involution of the reproductive organs

During the postpartum period in female body there is a process of involution (reverse development) of all systems, organs that have changed during pregnancy. This change begins from the moment the placenta falls off. It will take about 6 weeks. After the birth of the baby, there is a contraction of the uterus under the influence of postpartum contractions.

After the birth of the baby, the size of the uterus decreases, the bottom of which is located at this time at the level of the navel. The bottom is getting lower every day. So by the second day it is located slightly below the navel, by the 4th day - between the womb, navel, by 8-9 days - a little above the womb. After a while, she will take her place, which corresponds to the norm.

By this time, the shape of the uterus should change. It normally takes the following forms:

• Spherical - by the 3rd day;
• Oval - by the 5th day;
• Pear-shaped - by the 7th day.

Also observed by this period is a discharge from the genital tract, which is called lochia. They change their color from the first day after birth:

• Bright red - in 2 - 3 days;
• Pale - from the 3rd day;
• Yellowish - from the 5th day.

The discharge after a week becomes the same as before, before the onset of pregnancy.

What can an ultrasound detect?

• Sometimes there are deviations in the size of the uterus from the norm. The large size of this organ indicates the presence of subinvolution, which manifests itself in a slow reverse development. Ultrasound diagnostics helps to determine the cause of deviation from the established norm, the appointment of special treatment.
• Postpartum endometritis. By means of ultrasonic waves, a decrease in the tone of the uterus, the accumulation of gases in it, and the expansion of the cavity are detected. Treatment must begin immediately.
• Postpartum bleeding. To detect sudden bleeding, it is necessary to carry out diagnostics on the 2nd - 3rd day after childbirth. Ultrasound for preventive purposes contributes to the timely detection of remnants of placental tissue, fetal membranes in the uterine cavity.

If during the first ultrasound examination, the specialist found any pathological changes in the uterine structure, its condition, there is a need for re-diagnosis. The second ultrasound is done to evaluate the results of the therapy undertaken.

Prescribing ultrasound procedures after natural childbirth

Ultrasound after childbirth is necessary to perform an examination of the female reproductive system. The doctor has the ability to detect all kinds of complications and take measures for their timely treatment.

When the condition of the woman giving birth is normal in the postpartum period, ultrasound is prescribed only by the second or third day. Normally, the transabdominal method is used. It is more comfortable in the postpartum period. After all, it is quite difficult to examine a large uterus from the inside using a vaginal sensor. Transvaginal diagnostics is prescribed by a specialist in the case when it is necessary to carefully examine the cervix.

By means of ultrasound, the uterine cavity and its condition are evaluated. It should be slit-like, slightly expanded. Inside it is a small amount of blood, blood clots, which are localized in the upper part of the organ. This content will sink to the bottom on the 5th - 7th day.

The specialist during the examination notices various changes uterine cavity:

• Excessive expansion of the body;
• The presence of remnants of placental tissue;
• The presence of fetal membranes;
• Lots of blood, clots.

Such detailed diagnostics will help the doctor prevent the woman giving birth to various serious complications that may occur in the postpartum period. With ultrasound diagnostics, the size of the uterus is subject to mandatory assessment. The specialist compares the result obtained after the diagnosis with the indicators of the normative table. Below we give an example of normal uterine involution.

The length of the uterine cavity is reduced every day. The dynamics of its contractions is reflected in the table, taking into account the norm. The results were obtained in the study of the probe.

Changing the parameters of the uterus

Immediately after the birth of the baby, the weight of the uterus is in the range of 1,000 - 1,200 g. The length of this organ is 15 - 20 cm, it is measured from the external pharynx to its bottom.

Involution of the uterus is provoked postpartum contractions which may be accompanied by pain. In the process breastfeeding pain intensifies. The weight of the uterus decreases weekly:

• By the end of the first week, it decreases to 500 - 600 g;
• The end of the second - 350 g;
• The end of the third - 200 g;
• The end of the postpartum period - 60 - 70 years.

The level of uterine involution is determined by the height of the fundus. The normal weight of the uterus in a woman is 50 - 70 g. She should return to this weight some time after pregnancy.

Timing of the ultrasound

Diagnosis in normal childbirth:

• After childbirth, with their resolution in a natural way, ultrasound diagnostics of the uterus is done mainly by the 2nd - 3rd day.
• If a uterine rupture is suspected in a woman who has given birth, then an ultrasound after the birth of the baby is done in the first 2 hours. Ultrasound examination helps to detect bleeding, its causes.

Ultrasound for complications

In the presence of complications, ultrasound diagnostics should be done after childbirth. Early diagnosis helps to identify various deviations:

• Enlarged uterus;
• The insufficiency of its contractions;
• The rest of the children's place.

Ultrasound after caesarean section

Diagnosis is carried out shortly after the operation. Such haste will help to exclude internal bleeding, to consider the stitches applied to the uterus. Ultrasound examination after cesarean is necessary because after the operation the risk of various complications increases:

• endometritis;
• Bleeding.

The specialist observes the dynamics of the recovery process.

Indications for ultrasound

When discharged from the hospital, every woman in labor must undergo an examination. Examination of the internal organs is very important to exclude postpartum complications. Also this survey can appoint some time after discharge. The referral for ultrasound is issued by a specialist after examining the patient, familiarizing herself with her complaints.

Ultrasound diagnostics should be carried out urgently in such cases:

• The occurrence of increased bleeding;
• Soreness of the seam imposed as a result of the operation;
• Temperature rise;
• Isolation of liquid from the seam;
• The appearance of discharge with an unpleasant odor;
• Swelling, redness of the postoperative suture.

Indication for urgent implementation ultrasound diagnostics is the appearance blood secretions. Their presence may indicate the formation of a placental polyp in the uterine cavity. It is an outgrowth of placental tissue that forms on the wall of the uterus.

In some cases, the postpartum period can be dangerous and lead to serious complications. Since an external obstetric examination does not always allow a reliable assessment of the tone and real rates of uterine contraction, during medical practice actively use ultrasound after childbirth. The introduction of this diagnostic method in obstetrics and gynecology has reduced the frequency of postpartum hemorrhage and inflammation.

Ultrasound after natural childbirth

In most cases, physiological childbirth proceeds very well for both the woman in labor and the child. Therefore, if during delivery there were no complications, serious injuries or bleeding, then an ultrasound scan after childbirth is prescribed in the maternity hospital only on the second or third day in order to assess the size of the uterus, its tone and rate of involution.

The goals of this ultrasonography are:

• assessment of the true size of the uterus and its tone;
• exclusion of the presence in the uterine cavity of the remnants of the membranes, placenta and a large number blood clots;
• early diagnosis intrauterine bleeding and inflammation of the endometrium.

What can be found

Even taking into account the absence of any complaints from the part of the puerperal, in the early postpartum period, the doctor can detect the following changes by ultrasound:

1. Subinvolution of the uterus is a slowdown in the rate of reduction in the size of the organ to normal. This condition increases the risk of developing inflammatory processes and the attachment of infections, since adequate involution of the uterus contributes to the release of blood clots from its cavity and the discharge accumulated in it.
2. Bleeding - is determined using an expanded uterine cavity and the presence of liquid blood in it or a large number of clots. This complication often leads to a reduced tone of the organ, birth trauma, pathology of the hemostasis system (thrombocytopathy and thrombocytopenia, deficiencies of blood coagulation factors, etc.). At profuse bleeding a woman will definitely complain about the discharge from the genital tract spotting scarlet or dark brown.
3. Various infections and inflammatory processes. In endometritis, an ultrasound scan will show uneven contours of the uterus and heterogeneous echogenicity. Contribute to the appearance of postpartum endometritis can be late preeclampsia of a pregnant woman, a large fetus, prolonged or pathological childbirth(with a functionally narrow pelvis, improper presentation of the fetus), a long anhydrous period and a young age of the woman in labor (up to 19 years).

It is worth noting that high frequency postpartum infections of the reproductive system occurs:

• in women who smoke and abuse alcohol;
• those who have medical abortions or a history of spontaneous miscarriages;
• in pregnant women suffering from diabetes and having foci chronic infection(pyelonephritis, tonsillitis, sinusitis, etc.).

Normal performance

As mentioned above, after natural childbirth, ultrasound is done on the second or third day after the birth of the child. First of all, the uterus is examined, which should have a slit-like and slightly expanded shape, and its cavity should contain a small amount of blood clots and blood (in the upper pole of the organ). Approximately by the 6-7th day, all the contents go down and only by the end of the first week - the beginning of the second, the shape of the organ acquires normal outlines - it becomes pear-shaped.

On an early ultrasound of the birth field, the weight of the uterus ranges from 950-1000 grams. By the 7th day, its weight is almost halved and is 400-500 g. At the end of the 7-8th week of the postpartum period, the involution of the organ ends and its weight becomes 70-75 grams.

Normal size of the uterus depending on the day of the postpartum period

To date, caesarean section is the only right way out for most pathologies during pregnancy, as well as the individual desire of some women. However, many of them are afraid of a scar on the uterus after surgery, which can deform it and slow down involution.

After caesarean section early ultrasound carried out only according to indications:

1. The appearance of massive bloody discharge from the genital tract.
2. hyperthermia syndrome.
3. soreness sharp redness and severe swelling of the postoperative scar.
4. long and intense pain in the lower abdomen.
5. The appearance of pathological leucorrhoea, having bad smell and yellowish green.

Ultrasound of the suture placed on the wall of the uterus as a result of caesarean section is performed in order to identify its stability and thickness, exclude inflammation and predict next pregnancies. Normally, it looks like a hyperechoic strand located in the bottom area.

The great significance of uterine ultrasonography after caesarean section is that a high frequency of hidden on early stages bleeding and incidence of endometritis; it is also worth noting the presence of postoperative pain that can mask the clinic of inflammation or other complications.

Indications for ultrasound of the uterus after discharge

In the event that in the maternity hospital the woman was not performed ultrasound examination, she is advised to contact women's consultation in order to address the need for research. It is advisable to do this no later than the first 7 days after discharge.

If the puerperal is at risk or had any complications in the early postpartum period, then it is strongly recommended to do an ultrasound of the uterus after childbirth on the 7-8th day after discharge from the hospital.

If the period after delivery proceeded safely, and the first ultrasound after childbirth did not reveal any pathologies, then upon returning home, the woman is recommended to apply for repeated consultation to the gynecologist in about 30 days. After examination and questioning, the doctor will decide whether a second ultrasonographic screening is necessary.

Indications for the appointment of ultrasound after discharge are:

1. The appearance of blood from the genital tract. Often this testifies in favor of a placental polyp (growth of the mucous membrane at the site of attachment of the placenta).
2. An increase in temperature and a change in the nature of the secretions.
3. Pain in lower sections abdomen, failure of the seam, its redness, swelling and secretion of the ichor.

In this way, ultrasonic method examinations are of great help to obstetricians-gynecologists in the diagnosis and prevention of postpartum complications.

Why do ultrasound during pregnancy - everyone knows about this: to find out how the embryo develops, to determine pathologies, to establish the health status of the expectant mother. After childbirth, an ultrasound examination is necessary to monitor the process in which the uterus returns to its original state, changed by the onset of pregnancy.

How long the process of contraction of the uterus and normalization of the processes taking place in it? About six weeks. During this time, an ultrasound is mandatory.

When is an ultrasound indicated?

If after childbirth there is wall rupture suspected uterus, ultrasound should be done in two hours. In other cases, the procedure is prescribed after 2-3 days.

Regulatory Criteria:

• slight expansion is observed;
• the cavity is slit-like;
• a lot of blood or clots have accumulated in the upper part;
• if the study is carried out 5 or more days after birth, the clots are displaced to the lower wall of the uterus.

Methods for conducting ultrasound: with the help of a vaginal probe and with the help of an apparatus, the uterine wall is examined through the abdominal wall.

How is a postpartum ultrasound done?

Process postpartum ultrasound practically indistinguishable from conventional method, which was used when observing a woman at the time of her childbearing.

Transabdominal ultrasound

Carried out with a special device connected to the machine. Reminds me of a tube with a sensor. First, apply to the skin in the abdomen special agent to better see the state internal organ and its cavity, then the picture appears on the screen.

No pain or discomfort should be felt - the procedure is absolutely painless.

Vaginal ultrasound

This examination method is more complicated in that it is more difficult to assess the walls of the uterus during its implementation. However, if necessary examine the condition of the appendages and in general, the abdominal organs, it is necessary.

Talking about soreness It should be noted that the vaginal probe is placed in the uterine cavity and may cause some discomfort, especially if there were tears and stitches during childbirth.

Preparation for the procedure

Preparing for an ultrasound after childbirth is practically not required. The main thing when conducting an ultrasound examination is the absence of menstruation, however, if there is bleeding after childbirth, on the contrary, ultrasound is indicated urgently.

The most complete study can be carried out if you drink a liter of water two hours before the appointed time. The main thing at the same time is not to go to the toilet if you want. However, overfilled bladder- this is also a problem.

It is better to go to the toilet first, and then, be sure to drink two hours before the procedure. more water- in this case, you will not lose.

Duration of the procedure usually reaches 10 minutes, sometimes less. If a we are talking about a vaginal ultrasound, no preparation is required - you don’t even need to drink water or monitor when you went to the toilet.

If you become bad after ultrasound be sure to tell your doctor. If a vaginal examination method was performed, infection is possible, but only if safety and hygiene rules are not followed.

When is a study after a caesarean scheduled?

By virtue of physiological characteristics after caesarean section uterus shrinks more long time compared with natural childbirth. main reason- trauma to the uterine cavity (an incision that is made in order to fully reach the child).

If there is a possibility internal bleeding, ultrasound is prescribed immediately after surgery. If not, the study is carried out after 3-4 days. Often, bleeding still occurs, but in a small amount.

Parameters considered normal for normal childbirth, are also relevant for childbirth performed by caesarean section. However, the rate of uterine development is slower. The greater the chance of internal bleeding, there remains a high chance that the placenta will not be completely removed. Therefore, ultrasound after caesarean section is an important stage in recovery.

The norm of indicators of the size of the uterus

Exists special table , which spells out changes in the size of the uterus, which are considered the norm. The limits are calculated depending on the height and weight of the woman in labor, some features of her body.

• The length of the uterus on the second day after birth: 136-144 mm.
• The length of the uterus for 6-8 days after birth: 94-106 mm.
• The width of the uterus on the second day after birth: 133-139 mm.
• The width of the uterus for 6-8 days after birth: 95-105 mm.
• Anteroposterior size on the second day: 68-72 mm.
• Anteroposterior size on days 6-8: 61-69 mm.

The results are deciphered by a specialist in ultrasound diagnostics and an obstetrician-gynecologist. The uterus should not be tilted back, the external contours should be distinguished by clear lines. The size of the uterus is measured using a computer program.

Echogenicity should be homogeneous - this can be seen visually when examining the uterine cavity on the screen. The structure and size of the cervix is ​​​​estimated - it should gradually close depending on the time elapsed after childbirth.

If at least one pathology was detected in a woman in labor, then either at the stage of therapy or after it, more ultrasound examinations. The frequency of ultrasound does not affect the health of the woman and does not affect the quality of breast milk.

Uterus contraction

Usually, a woman's uterus after childbirth weighs 1 kg. Within a week, her weight is halved, then, after another week, by another 35%, then reaches 250 grams ( average). Two months after the birth of the baby, the uterus should weigh 75 grams.

Main problems and pathologies

If anomalies are recorded by the doctor, the problem is solved in the near future. This will avoid complications and the development of diseases.

Clot accumulation

What problems can arise? First of all, this accumulation excessive clots blood in the uterine cavity. If for one of the reasons the placenta remains, ultrasound helps to establish this, in which case it is necessary to take action. Usually, in a maternity hospital, cleaning is carried out if the woman in labor has not yet been discharged.

Expansion of the uterus (subinvolution)

Overly enlarged uterus, which does not decrease in size - this is also possible. Usually, appropriate drugs are prescribed to carry out the process of contraction of the muscles of the uterus.

endometritis

With this disease uterus is too weak, gases accumulate in it, often the remains of the placenta and other membranes of the fetus remain. The solution to the problem is the appointment of drugs that help the uterus contract, as well as antibiotics.