Postpartum Uterus

Question 1

What is the Puerperium period?

Answer 1

Expulsion of placenta and uterine contents to 6-8 weeks after birth OR when uterus regains its normal shape

Question 2

What does POVT stand for?

Answer 2

Postpartum Ovarian Vein Thrombophlebitis

Question 3

When does involution of the uterus usually occur?

Answer 3

1 week after delivery

Question 4

What causes the resuming of normal menstrual cycle after birth?

Answer 4

Discontinuance of lactation

Question 5

Size of postpartum myometrium?

Answer 5

7-10cm

Question 6

When should endometrial thickening go back to normal?

Answer 6

End of the postpartum period

Question 7

What should free fluid in the endometrial cavity measure to be normal?

Answer 7

No greater than 1.2 to 1.4cm

Question 8

If fluid in the endometrial cavity following measures 1.1cm, is it considered normal?

Answer 8

YES: no greater than 1.2 to 1.4 cm

Question 9

Width of uterus after birth?

Answer 9

7-14 cm

Question 10

Length of uterus after birth?

Answer 10

14-25 cm

Question 11

What usually results in emergency hysterectomy?

Answer 11

Acute hemorrhage

Question 12

Bleeding occurring over several days to a few weeks after birth is known as?

Answer 12

Delayed hemorrhage

Question 13

Postpartum hemorrhage is classified as how many mL with vaginal birth and with C-section?

Answer 13

1. Vaginal birth = 500mL
2. C-section = 1000mL

Question 14

What is the most common cause of postpartum hemorrhage?

Answer 14

Placenta accreta

Question 15

What is puerperal infection characterized by?

Answer 15

Temperature of 38 degrees or higher on any 2 successive days after the first 24 hours postpartum

Question 16

What is usually the first sign of infection?

Answer 16

Uterine tenderness

Question 17

What is lochia?

Answer 17

Discharge in puerperal period

Question 18

What may be the cause of odorous lochia postpartum?

Answer 18

Uterine infection

Question 19

What are the most common kind of puerperal infection?

Answer 19

UTI

Question 20

What does VBAC stand for?

Answer 20

Vaginal Birth After C-section

Question 21

What may increase the incidence of endometritis?

Answer 21

Vaginal delivery after c-section

Question 22

Sonographic features of endometritis?

Answer 22

1. Thick
2. Irregular
3. May have fluid in endocervical canal

Question 23

Patient seen with gas in endocervical canal 4 weeks after delivery, is this normal?

Answer 23

No: Gas may be seen up to 3 weeks after delivery, but is abnormal after 3 weeks

Question 24

Patient seen with gas in endocervical canal 1 week after delivery. Is this finding significant?

Answer 24

NO: Gas is normal within endocervical canal up to 3 weeks postpartum

Question 25

A highly echogenic mass is seen within the endometrium postpartum. What may this be?

Answer 25

RPOC

Question 26

What postpartum abnormality may be the cause of having indistinction between the endometrium and myometrium? AKA losing differentiation between the two

Answer 26

Endometritis

Question 27

What is one of the most common causes of postpartum hemorrhage?

Answer 27

Uterine atony

Question 28

What is the term for the postpartum uterus that is flaccid and unable to hold its shape?

Answer 28

Atony

Question 29

Define thrombophlebitis

Answer 29

Inflamed vein due to a thrombus in the vessel lumen

Question 30

What are other reasons other than postpartum that can cause POVT?

Answer 30

1. PID 2. Malignancies

Question 31

What is Virchow's triad?

Answer 31

Related to POVT 1. Venous stasis 2. Hypercoagulation of blood 3. Damage to venous walls

Question 32

Venous damage in PVOT is due to what?

Answer 32

The expansion and contraction of the uterus

Question 33

Which ovarian vein is usually affected in PVOT?

Answer 33

Right

Question 34

Sonography captures images of anechoic tubular structures that extend superiorly from the adnexa in a postpartum woman. What may be the cause?

Answer 34

Postpartum ovarian vein thrombophlebitis

Question 35

What are the most common symptoms of PVOT?

Answer 35

Pelvic pain R sided mass Fever Usually felt within the first 48-96 hours postpartum

Question 36

What is a complication due to a c-section?

Answer 36

Hematoma at the bladder flap

Question 37

What is most commonly seen at the bladder flap in postpartum c-section?

Answer 37

Hematoma

Question 38

What factors may cause infection after a c-section? (4)

Answer 38

1. Contaminated amniotic fluid entering incision 2. When there is already an infection 3. Endometritis 4. Long operating time

Question 39

What two places can infection occur after c-section?

Answer 39

1. Abdominal wall 2. Uterine wall

Question 40

What causes the formation of a placental polyp?

Answer 40

Placental tissue remaining in uterus after birth

Question 41

When do symptoms of PVOT usually present?

Answer 41

within 48-96 hours after birth