Postpartum Uterus Flashcards
What is the Puerperium period?
Expulsion of placenta and uterine contents to 6-8 weeks after birth OR when uterus regains its normal shape
What does POVT stand for?
Postpartum Ovarian Vein Thrombophlebitis
When does involution of the uterus usually occur?
1 week after delivery
What causes the resuming of normal menstrual cycle after birth?
Discontinuance of lactation
Size of postpartum myometrium?
7-10cm
When should endometrial thickening go back to normal?
End of the postpartum period
What should free fluid in the endometrial cavity measure to be normal?
No greater than 1.2 to 1.4cm
If fluid in the endometrial cavity following measures 1.1cm, is it considered normal?
YES: no greater than 1.2 to 1.4 cm
Width of uterus after birth?
7-14 cm
Length of uterus after birth?
14-25 cm
What usually results in emergency hysterectomy?
Acute hemorrhage
Bleeding occurring over several days to a few weeks after birth is known as?
Delayed hemorrhage
Postpartum hemorrhage is classified as how many mL with vaginal birth and with C-section?
- Vaginal birth = 500mL
- C-section = 1000mL
What is the most common cause of postpartum hemorrhage?
Placenta accreta
What is puerperal infection characterized by?
Temperature of 38 degrees or higher on any 2 successive days after the first 24 hours postpartum
What is usually the first sign of infection?
Uterine tenderness
What is lochia?
Discharge in puerperal period
What may be the cause of odorous lochia postpartum?
Uterine infection
What are the most common kind of puerperal infection?
UTI
What does VBAC stand for?
Vaginal Birth After C-section
What may increase the incidence of endometritis?
Vaginal delivery after c-section
Sonographic features of endometritis?
- Thick
- Irregular
- May have fluid in endocervical canal
Patient seen with gas in endocervical canal 4 weeks after delivery, is this normal?
No: Gas may be seen up to 3 weeks after delivery, but is abnormal after 3 weeks
Patient seen with gas in endocervical canal 1 week after delivery. Is this finding significant?
NO: Gas is normal within endocervical canal up to 3 weeks postpartum
A highly echogenic mass is seen within the endometrium postpartum. What may this be?
RPOC
What postpartum abnormality may be the cause of having indistinction between the endometrium and myometrium? AKA losing differentiation between the two
Endometritis
What is one of the most common causes of postpartum hemorrhage?
Uterine atony
What is the term for the postpartum uterus that is flaccid and unable to hold its shape?
Atony
Define thrombophlebitis
Inflamed vein due to a thrombus in the vessel lumen
What are other reasons other than postpartum that can cause POVT?
- PID
- Malignancies
What is Virchow’s triad?
Related to POVT
- Venous stasis
- Hypercoagulation of blood
- Damage to venous walls
Venous damage in PVOT is due to what?
The expansion and contraction of the uterus
Which ovarian vein is usually affected in PVOT?
Right
Sonography captures images of anechoic tubular structures that extend superiorly from the adnexa in a postpartum woman. What may be the cause?
Postpartum ovarian vein thrombophlebitis
What are the most common symptoms of PVOT?
Pelvic pain
R sided mass
Fever
Usually felt within the first 48-96 hours postpartum
What is a complication due to a c-section?
Hematoma at the bladder flap
What is most commonly seen at the bladder flap in postpartum c-section?
Hematoma
What factors may cause infection after a c-section? (4)
- Contaminated amniotic fluid entering incision
- When there is already an infection
- Endometritis
- Long operating time
What two places can infection occur after c-section?
- Abdominal wall
- Uterine wall
What causes the formation of a placental polyp?
Placental tissue remaining in uterus after birth
When do symptoms of PVOT usually present?
within 48-96 hours after birth
