An important diagnostic examination of the mother is an ultrasound after childbirth: all the intricacies of the procedure and the meaning of the indicators. Norms for the size of the uterus according to ultrasound during pregnancy and after childbirth

So, yesterday we started a conversation about what happens to a woman during the postpartum period and how it is possible to identify early stages health problems and the formation of serious postpartum complications. This helps at the initial stage active treatment, which will allow a woman to save reproductive functions and not earn yourself chronic pathologies for life. So, what can specialists at a maternity hospital or antenatal clinic see on an ultrasound examination during the postpartum period?

Formation of postpartum endometritis

Postpartum endometritis is called inflammation of the endometrium of the uterus (its inner mucous membrane). 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 tissue or fragments of fetal membranes. It is important for yourself 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 be able to 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 uterine contractions are required. If treatment is not started immediately after diagnosis, endometritis can progress to 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 is worth noting that today this pathology is thanks to timely diagnosis and prevention occurs infrequently, in approximately 2% of cases of women who give birth naturally.

Formation postpartum hemorrhage

Postpartum hemorrhage can be a serious complication of natural or operative childbirth. Carrying out an ultrasound examination on the second or third day from the moment of birth will help prevent such dangerous complications in the postpartum period. Bleeding may start suddenly and can be very heavy at times. Often, the causes of incipient bleeding can be remnants of placental tissue remaining in the uterine cavity, remnants of fetal membranes inside the uterine cavity, and this can be easily diagnosed during ultrasound monitoring 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 remnants of placental tissue. If during the initial ultrasound examination in the postpartum period any pathologies were detected, then the study is carried out with the regularity necessary to monitor the dynamics of the process and evaluate the effectiveness of the measures taken. In case of positive dynamics and good results control ultrasound, the young mother and baby are discharged from the maternity hospital under the supervision of doctors at the antenatal clinic. But in case of the slightest doubt, the doctor will immediately refer the woman to a gynecological hospital.

After the operation caesarean section

A cesarean section is a special type of genital surgery that allows a baby to be born. And like any operation, this one is also not performed just like that, without indications; to carry it out, it is necessary to have certain indications - relative or absolute. And after a cesarean section, the uterus will return to its previous size much more slowly than the same process during natural childbirth. The reasons for this include disruption of the structure of the muscle fiber in the area of the uterine wall due to the incision and subsequent suturing, which results in the formation of a scar on the uterus. During a cesarean section, the uterus acquires the size and shape of the uterus as it was before pregnancy only on the 10th day of the postpartum period.

In addition, the mere performance of a cesarean section on a woman in labor significantly increases the risks various kinds complications. Endometritis occurs more often after childbirth, the frequency of bleeding increases, and it can be external, blood pouring out of the vagina, or internal bleeding with accumulation of blood in the 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 surgically.

Usually an ultrasound examination of the uterus and reproductive organs for a woman who has given birth to a child by cesarean section, it is prescribed within a period of three to four days from the date of the operation. But sometimes, in some cases, as prescribed by the doctor, ultrasound examinations may be prescribed during the first few hours after the operation to exclude bleeding in the abdominal cavity or disruption 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 from women, especially with indications of abdominal pain, in the presence of poor blood tests, especially with sharp decline hemoglobin and hematocrit after surgery. An ultrasound examination can be carried out either through the anterior abdominal wall(transabdominal) and through the vagina with a vaginal sensor.

An ultrasound evaluates approximately the same parameters as during a normal natural birth, but in addition, a mandatory examination of the scar in the uterine area is carried out. Often, it is the condition of the scar that will be evidence of certain pathologies, for example, an ultrasound sign of postpartum endometritis during cesarean section is swelling of the sutures of the uterus. The healing of sutures during a cesarean section does not always occur smoothly, in such cases ultrasonography helps in diagnosing hematomas (collections of blood) in the area of the surgical scar, and also helps in monitoring the size and size, location of hematomas, and determines the choice of treatment method.

Ultrasound for monitoring of detected pathology is carried out repeatedly, as prescribed by a doctor, to assess the dynamics of the process and the effectiveness of treatment. If the dynamics are positive and there is no danger to the woman’s health, she is discharged home from the maternity hospital under the supervision of a doctor at the antenatal clinic. When performing an ultrasound, women after childbirth, be it a natural birth or a cesarean section, are required to 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 - under normal conditions they should be absent. In addition, it is important to assess the condition of the uterine veins and surrounding tissue

After leaving the hospital

If you did not have an ultrasound for some reason while still in the maternity hospital, it is necessary mandatory spend in the antenatal clinic along with a visit to the gynecologist during the first week after discharge from the hospital to home. It is also important to determine the need for an ultrasound scan if this study was carried out in the maternity hospital and there were any manipulations or therapeutic effects. Thus, all women who are at risk for postpartum complications, as well as those who had complications during childbirth, must undergo an ultrasound of the uterus five to eight days after discharge from the hospital. Conducting an ultrasound within these periods will help prevent late complications or recurrence of endometritis. The risk group is multiple pregnancy and polyhydramnios, protracted labor and blood loss during childbirth, a long anhydrous interval, manual control over the separation of the placenta.

If, according to the results of the 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 examination are necessary for monitoring after discharge from the maternity hospital. You definitely need to go to the gynecologist in the first month after giving birth, and the doctor will determine the need for an ultrasound after examination; if no abnormalities are found, your next visit to the doctor awaits you six months after the birth.

To whom and when is ultrasound indicated?

Indications for immediate ultrasound after childbirth may include:

Increased bleeding from the genital tract, which may indicate the presence of placental remnants in the uterine cavity, placental polyp, which is clearly visible on ultrasound and is an indication for curettage of the uterine cavity;
- an increase in temperature, a 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 an infection. This requires immediate treatment;
- painful and discomfort in the lower abdomen, in the area of the cesarean section scar, which may indicate failure of the suture or its divergence.

During pregnancy, the need for an ultrasound is justified. The postpartum period is considered the time when organs that have undergone changes are restored. It is recommended to do an ultrasound after childbirth to know about the condition of the reproductive organs. If there are deviations or diseases, it is necessary to immediately begin to eliminate them.

In case of pathologies, ultrasound examination is carried out within 24 hours after the birth of the child. Diagnostics is used when the birth was unsuccessful, the uterus contracts weakly, there is pain, and severe bleeding. These actions will allow you to assess the health status of the young mother and develop a treatment method.

The timing of the first ultrasound examination is determined:

degree of severity of the birth process;
length;
general health of the mother in labor.

Factors when deciding whether to conduct a diagnosis are the method of delivery: independent or surgical intervention. The first study is carried out on the eve of discharge. If for some reason it does not take place, the diagnosis is made within 4-6 days. The procedure makes sure that the patient is absolutely healthy, there is no pathology, and recovery is proceeding normally.

Ultrasound is performed without vaginal sensors. The condition of the reproductive organ is examined through abdominal cavity. The abdominal method does not require preparation on the part of the woman in labor. The main requirement is complete bladder. If an emergency examination is necessary, the fluid is administered through a special catheter.

Diagnosis after natural birth

If there is heavy bleeding due to uterine ruptures, it is necessary to conduct an ultrasound examination immediately after the baby is born. The obstetrician chooses this diagnostic method to establish accurate diagnosis, identify the causes of complications that have arisen.

Why do an ultrasound after childbirth:

see how much fluid has collected inside the abdominal cavity;
analyze the presence of thick blood formations;
examine the ovaries;
see the condition of the surrounding fiber.

What kind of ultrasound is done after childbirth? The most appropriate transabdominal method is used. The examination is carried out through the abdominal wall due to large sizes reproductive organ. The vaginal sensor is not used in this situation.

The condition of the internal cavity of the uterus is considered important indicator assessing the health of the mother's body. Normal - slight expansion due to accumulation of large quantities blood located in the upper part. After a week, the blood clots move to the bottom.

Ultrasound of the uterus reveals:

remnants of the placenta;
excessively dilated uterine cavity;
presence of membranes;
high content of blood clots.

Identifying deficiencies in a timely manner prevents serious complications. The postpartum period proceeds calmly. The examination helps to assess the size of the organ. If everything is fine with the baby and mother, your stay in the maternity hospital will last no more than 3 days.

Measurement standards

Uterine parameters are assessed at ultrasound diagnostics, weight decreases weekly. The normal size of the uterus after childbirth is equal to 20 weeks of gestation. The fundus is palpated 4 cm below the navel.

The size of the uterus on the 3rd day reaches 120 mm long, 115 mm wide. Then, over 6–8 weeks, the organ contracts. The weight decreases to the prenatal level. By the end of the 1st week, the organ reaches 500 g, the 2nd - 350 g, the 3rd - 200 g. Normal sizes uteri correspond to prenatal ones. They are individual for each mother and are associated with body parameters.

The length of the uterine cavity decreases gradually. After labor activity the weight is approximately a kilogram, the length is measured from the external pharynx to the fundus, the norm of the uterine cavity is 15 - 20 cm. The parameters gradually decrease during involution. Postpartum contractions accompany painful sensations, during breastfeeding they are intensifying. The height of the bottom determines the level of involution.

After the baby is born reproductive organ decreases 8 times, then gradual involution occurs. The uterine cavity shrinks by 2–3 cm every day. The organ is restored gradually, changes occur individually. Dimensions for discharge correspond to normal terms involution.

During an ultrasound after childbirth in the maternity hospital, they look at the tone, structure, cervical canal, and ovaries. The mother is discharged on the 3rd day after labor in a natural way if there are no complications. When the result is a bad ultrasound, the length of stay of the woman in labor in the maternity hospital is increased.

Ultrasound for complications

If after childbirth there are unpleasant symptoms, the obstetrician uses ultrasound to determine their nature, causes, size, and position. Early diagnosis makes it possible to identify emerging complications.

What does an ultrasound after childbirth show:

insufficient contraction of the uterus;
pathological large size;
The child's place did not come out completely.

If the size of the organ exceeds the required size, this fact is associated with polyhydramnios, a large fetus, and bearing several children at the same time. Otherwise we're talking about about pathology. Ultrasound readings of the uterus after childbirth will indicate the cause of the deviation and help develop tactics for further activities. At first, the mother's condition is under medical supervision, they use drug treatment aimed at reducing the genital organ.

An ultrasound performed on days 2–3 helps prevent bleeding caused by placental remnants. They begin unexpectedly and flow profusely. To stop, curettage is practiced, removing the remnants of the amniotic membrane. Endometritis rarely occurs after childbirth.

Signs of pathologies:

the uterine cavity is expanded;
low tone;
gases have accumulated;
remnants of the placenta.

Treatment of the disease should begin immediately after detection, discharge medications. A prolonged form of the disease leads to removal of the organ.

When to do an ultrasound after childbirth? The first diagnosis is carried out 2-3 days after the birth of the baby in a natural way. When the doctor suspects inflammation, the study is carried out after the first symptoms are detected.

If there is a complication, an ultrasound in the maternity hospital after childbirth is performed immediately after delivery. If all indicators are normal, you can do an ultrasound 2 months after birth. Patency fallopian tubes analyzed at the end of the cycle.

Diagnosis after cesarean section

The reproductive organ takes longer to recover after surgery than after childbirth naturally. This occurs due to disruption of the muscle structure during surgery. The uterus returns to shape only on the 10th day.

After a cesarean section, there is a risk of developing various complications, endometritis often appears. About 5% of women suffer from severe bleeding: external, when blood flows out of the vagina, internal, when blood flows into the abdomen. An ultrasound examination is performed shortly after the operation. Its purpose: to check the sutures, the amount of blood inside to exclude large amounts.

Postpartum ultrasound of the uterus after cesarean section is done on days 3–4. Early diagnosis is prescribed when the mother complains of intensive pain syndrome. Poor blood tests and low hemoglobin also speed up the examination.

Ultrasound is performed in two ways:

transabdominal;
vaginal sensors.

The purpose of the examination is to determine the condition of the uterus, which after natural birth, plus seam analysis. Often, deviations in the scar indicate the formation of various complications. Swelling of the skin near the suture indicates the onset of endometritis. The incision does not always heal immediately well. Ultrasound diagnoses hematomas: their size and location are analyzed, and a course of treatment is prescribed.

If pathology is noted, ultrasound examination is performed repeatedly. How long after childbirth the ultrasound is repeated depends on the mother’s well-being; changes are assessed over time.

Indications for re-examination

If a woman in labor was discharged on the 3rd day, but an ultrasound was not performed, it is necessary to visit a doctor as soon as possible. Mothers who are at risk and have complications are recommended to undergo an ultrasound scan in the postpartum period for 8 days. An examination will help avoid relapses.

Women at risk include:

with a large volume of fluid in the uterine cavity after childbirth;
long labor process;
multiple pregnancy;
excessive blood loss during labor;
a long period of time between the breaking of water and the appearance of the child;
separating the placenta by hand.

When the examination was carried out in the maternity hospital, and after discharge the mother is not worried about anything, she needs to be examined again. Complications appear within 3-6 weeks after birth. It is recommended to undergo an ultrasound scan one month after labor.

Indications for pelvic ultrasound:

heavy bleeding;
heat;
discharge accompanied by an unpleasant odor;
pain syndrome in the lower abdomen.

If the indicators are normal, the next visit will be in six months. The procedure algorithm is directly dependent on the method indicated by the obstetrician. During a transabdominal examination, the woman in labor exposes her stomach and lies on her back.

How to do an ultrasound of the uterus after childbirth:

on skin covering a special gel is applied;
the sensor is placed on the lower abdomen;
the doctor analyzes the information received;
fixes it;
gives to the patient.

During a vaginal examination, a special sensor is used, onto which a disposable condom is placed to avoid infectious infections.

The normal course of the postpartum period is due to uniform contraction of the uterus. If recovery is slow, you must be under medical supervision. To prevent complications, maintain personal hygiene.

While expecting a baby, a woman must undergo at least three ultrasound examinations. However, a woman should have an ultrasound after childbirth to assess the condition of the genitals after such a serious load. Let's consider when and why an ultrasound of the uterus is performed after childbirth, whether it is performed after a cesarean section, and what a doctor can diagnose after such a procedure.

Of course, after such happy date a woman thinks only about the newborn child. However, this does not mean that you do not need to take care of her health. IN postpartum period A woman in labor needs to have an ultrasound performed in order to detect the slightest deviation from the norm in the condition of the genital organs.

An ultrasound of the uterus is usually performed on the second or third day after the birth of the child. For this, a transabdominal diagnostic method is used. This means that the doctor conducts an examination through the abdominal wall. The choice of transabdominal examination is determined by the fact that the size of the uterus during this period is still quite large, and the doctor will not be able to fully examine it using a vaginal sensor.

This method is the most optimal for women after childbirth. The convenience of this method is explained by the fact that after childbirth the uterus increases in size and examining it with a sensor for vaginal diagnostics is a problem.

A vaginal examination is performed only for a detailed examination of the condition of the cervix. It is imperative that a specialist analyze the condition of the uterine cavity after birth.

Transvaginal examination allows you to study the condition of the cervix in more detail, however, this method is used quite rarely due to the complexity of the procedure in the postpartum period

The ultrasound norm suggests that the cavity may be slightly expanded, since it is visualized a small amount of clots. On the second or third day they are localized in the upper part, and then move to its lower part.

The size of the uterus according to ultrasound is the norm after delivery

As a rule, the postpartum period is considered to be the time after the delivery of the placenta and lasts in some cases up to six weeks.

During this period, the so-called involution takes place, that is, a kind of reverse development of the genital organs, which were subjected to the greatest load and changes.

Ultrasound signs of normality after the birth of a child are as follows:
the uterus gradually becomes smaller in size (every subsequent day its bottom drops lower and lower)
on the fourth day the organ is located between the womb and the navel;
by the end of the third day after birth, the uterus becomes spherical;
by the fifth day its shape changes to oval;
after a week the uterus becomes pear-shaped.

Other standards

Normal indicators of the involution process of the uterus can be shown in the form of a table.

Normal indicator (uterine size)	Second day	4th day	6 – 8 days
Uterus length	13.6 – 14.4 cm	11.5 – 12.5 cm	From 9.4 to 10.6 cm.
Uterus width	From 13.3 to 13.9 cm	11.1 – 11.9 cm	9.5 – 10.5 cm
Anterior-posterior size	6, 8 – 7.2 cm	6, 5 – 7, 1	6.1 – 6.9 cm
Uterine cavity length	14.9 – 15.3 cm	8.9 – 9.5 cm	7 – 7.8 cm
Width of the uterine cavity	10, 4 – 11, 6	4-4,6	3.1 – 3.5 cm
Anterior-posterior size of the uterine cavity	5.1 – 7.1 cm	3 – 5 cm	2,8 – 3,6

Note that the weight of the uterus should change very quickly. It can also be determined using an ultrasound examination. So, after the birth of the baby, in the first hours the weight of this organ ranges from 1 to 1.2 kg. Sometimes during the process of reducing the size of the uterus there is pain. This is quite normal: they go away after a while.

The weight of the uterus normally decreases as follows:

on the 7th day it weighs approximately 500 - 600 g;
on the 14th day – about 350 grams;
in the third week the weight of the uterus should be about 200 g;
at the end of the postpartum period, the uterus weighs no more than 60 grams.

Other points observed on ultrasound

Such indicators may not always be observed in reality. Sometimes the doctor may notice such deviations from normal development uterus in the postpartum period (in such cases it is customary to talk about involution disorders):

In some cases, the doctor notes some deviations in the size of the uterus from normal.
Endometritis. Unfortunately, inflammation of the uterine cavity after childbirth occurs quite often. And the doctor, using ultrasound, can detect a decrease in the tone of the uterus and the presence of gas accumulation in it.
Postpartum hemorrhage. It is precisely ultrasound on the second or third day that makes it possible to detect the greatest risk of developing postpartum hemorrhage.
Sometimes after the birth of a child, a specialist can see the presence of fetal membranes and remnants of placental tissue in the uterine cavity.
Subinvolution of the uterus is a fairly common disorder visualized by ultrasound. This is an increase in the size of the uterus. Sometimes this process is normal condition(after multiple births, a large child, a large amount of amniotic fluid, etc.). It often occurs in women who have given birth many times.

Ultrasound after being in the maternity hospital

Many women are interested in whether an ultrasound examination is indicated after discharge. General rule states that if the examination was not carried out immediately before discharge, the woman must attend a gynecological consultation within seven days after she is discharged home in order to undergo this type of examination.

If the patient is at increased risk of bleeding or other complications, then an ultrasound should be done no later than the 5th day after discharge from the maternity hospital.

This group includes patients:
after multiple or polyhydramnios pregnancy;
if they had a prolonged labor;
if there was a long time interval between the rupture of amniotic fluid and the birth of the child;

if the afterbirth was separated manually. The examination must be repeated 30 days after birth. This is due to the fact that complications that are dangerous to health and life after the birth of a child can appear even later. late period

. The next preventive examination, provided that there were no complications, should be carried out approximately six months after birth. It is needed to make sure that everything is in order with the mother’s body.

When is it necessary to do an ultrasound urgently? There are cases when a woman is sent for an ultrasound immediately to determine the methodology for further research.

Pay attention to these warning signs. Appearance bloody discharge
from the vaginal tract (especially if they intensify). This suggests that there is a fragment of the placenta in the uterus. Ultrasound clearly shows the presence of a placental polyp, and subsequently it is curetted.
Increased body temperature.
Discharge with a bad odor. Pain of different nature
in the lower abdomen.
Pain in the suture area (after caesarean section).

Release of fluid from the postoperative suture.

We remind you that an urgent ultrasound examination should never be ignored - it often helps to save a woman.

Ultrasound of the uterus after cesarean section Features of uterine recovery after such surgical intervention

The point is that this process is somewhat slower. This occurs due to a violation of the muscle structure. However, even after such an intervention there is a norm.

It indicates that the shape and size of the uterus returns to prenatal values only after ten days after birth.

The postpartum period after such an intervention can become noticeably more complicated:
severe endometritis;
more heavy bleeding;

An ultrasound after a cesarean section is usually scheduled on the third or fourth day after the baby is born. Often this examination is done a few hours after the operation is completed.

Indications for such an examination are violation of the integrity of the sutures on the uterus. In addition, ultrasound after cesarean section is performed for the following indications:

the patient complains of severe pain;
poor blood tests (low hemoglobin levels).

In such a study, the same parameters are checked as after natural childbirth. Another one is added to them - a post-operative scar on the uterus. The appearance of scar edema is an ultrasound sign of developing endometritis. Ultrasound is also prescribed for a woman to diagnose a hematoma in the area of a postoperative scar.

It should be noted that control diagnostics after cesarean section are carried out repeatedly. There is no harm from repeated ultrasound examinations of the uterus after such an operation: ultrasound does not pose any danger to the woman’s body.

During subsequent examinations, the doctor must check:

condition of the gonads - ovaries;
accumulation of fluid in the abdominal cavity (ascites);
the appearance of blood clots;
condition of the uterine veins;
the condition of the fiber near the uterus.

Conclusion

Ultrasound after the birth of a child is an extremely important way to study the condition of a woman’s body. And it is a mistake to think that it is done only before childbirth. Just after childbirth, the specialist must make sure that the woman’s body is developing normally and that complications do not develop in it. Moreover, ultrasound is prescribed to the patient as much as necessary for a comprehensive and accurate diagnosis of the condition.

Under no circumstances should a woman refuse scheduled and necessary ultrasound examinations. This diagnostic method is completely safe for health.

Based on the results of the examination, a diagnosis is established and the necessary treatment is prescribed.

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 rate of uterine contraction, ultrasound is actively used in medical practice after childbirth. The introduction of this diagnostic method into obstetrics and gynecology has reduced the incidence of postpartum hemorrhage and inflammation.

In most cases, physiological childbirth proceeds very well for both the mother and the child. Therefore, if there were no complications, serious injuries or bleeding during delivery, then an ultrasound after birth 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 such ultrasonography are:

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

What You Can Find

Even taking into account the absence of any complaints from the parturient woman, in the early postpartum period the doctor may detect the following changes by ultrasound:

Subinvolution of the uterus is a slowdown in the rate of decrease in the size of the organ to normal. This condition increases the risk of developing inflammatory processes and the addition of infections, since adequate involution of the uterus promotes the release of blood clots and discharge accumulated in it from its cavity.
Bleeding - determined by an enlarged uterine cavity and the presence of liquid blood or a large number of clots in it. This complication is often caused by decreased organ tone, birth trauma, pathology of the hemostatic system (thrombocytopathies and thrombocytopenia, deficiencies of blood coagulation factors, etc.). If there is heavy bleeding, a woman will definitely complain of scarlet or dark brown bloody discharge from the genital tract.
Various infections and inflammatory processes. With endometritis, an ultrasound scan will show uneven contours of the uterus and heterogeneous echogenicity. Late gestosis of a pregnant woman, a large fetus, prolonged or pathological birth(with a functionally narrow pelvis, malpresentation of the fetus), a long anhydrous period and the young age of the woman in labor (up to 19 years).

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

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

Normal indicators

As mentioned above, after a natural birth, an ultrasound is performed 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 bloody clots and blood (in the upper pole of the organ). By about the 6-7th day, all the contents descend downwards and only by the end of the first week or the beginning of the second, the shape of the organ acquires normal shape - it becomes pear-shaped.

On an early ultrasound, the weight of the uterus fluctuates between 950-1000 grams. By the 7th day, her weight is almost halved and amounts to 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

Day	Indicators
	Length, mm	Width, mm	Anteroposterior size, mm	Cavity length, mm	Cavity width, mm
2nd	137-145	134-140	69-73	50-54	105-116
4th	116-126	110-120	66-70	90-94	41-47
6th	103-106	100-105	65-69	74-78	34-38
8th	94-98	95-97	61-64	70-73	30-33

Today, a cesarean section is the only correct solution 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 cesarean section, early ultrasound is performed only if indicated:

The appearance of massive bloody discharge from the genital tract.
Hyperthermic syndrome.
soreness, sharp redness and severe swelling of the postoperative scar.
Long and intense painful sensations of different nature
The appearance of pathological leucorrhoea with bad smell and yellowish-green color.

Ultrasound of a suture placed on the wall of the uterus as a result of cesarean section is performed to determine its stability and thickness, exclude inflammation and predict next pregnancies. Normally, it has the appearance of a hyperechoic cord located in the fundus.

The great significance of ultrasonography of the uterus after cesarean section lies in the fact that a high frequency of hidden initial stages bleeding and incidence of endometritis; It is also worth noting the presence of postoperative pain that can mask the symptoms of inflammation or other complications.

Indications for ultrasound of the uterus after discharge

If a woman did not undergo an ultrasound examination in the maternity hospital, she is recommended to contact the antenatal clinic to decide whether the examination is necessary. It is advisable to do this no later than the first 7 days after discharge.

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

If the period after delivery proceeded well, and the first ultrasound after childbirth did not reveal any pathologies, then upon returning home the woman is advised to seek a second consultation with a gynecologist after about 30 days. After examination and questioning, the doctor will decide whether repeat ultrasonographic screening is necessary.

Indications for prescribing ultrasound after discharge are:

The appearance of blood from the genital tract. Often this indicates a placental polyp (proliferation of the mucous membrane at the placenta insertion site).
Increase in temperature and change in the nature of discharge.
Pain in lower sections abdomen, failure of the suture, its redness, swelling and discharge of ichor.

Thus, ultrasonic method examinations provide great assistance to obstetricians and gynecologists in diagnosing and preventing postpartum complications.

Such a study began to be used in obstetric and gynecological practice 58 years ago. Its use made it possible to see what happens in a woman’s body during pregnancy and after childbirth. External obstetric examination cannot provide a complete picture. And by the speed of the process one can judge the success of the postpartum period. This fact speaks in favor of carrying out Ultrasound after childbirth. The picture shows the normal position of the uterus.

What is involution? Involution of the reproductive organs?

In the postpartum period, involution occurs of organs that changed during gestation. This is the process of returning to the position you had before pregnancy. But for different organs this happens in different time. The hormonal system and mammary glands complete their return to their original state after the end of lactation, but the uterus begins the process of contraction immediately after childbirth, and it lasts about 2 months. In women who breastfeed, the process of involution occurs much faster, and the uterus shrinks significantly already in the first days of the postpartum period. After 2 weeks, its bottom appears to be lowered to the level of the pubis.

Sometimes myoma is in a state of involution if myomatous processes occur in it. But fibroids sometimes slow down the return of the uterus to normal.

What can be detected using ultrasound?

After childbirth, an ultrasound examination is performed on the third day, even if the birth was difficult. Ultrasound helps to identify inflammatory process or determine whether internal bleeding and other postpartum complications. Getting tested can help prevent the development of sepsis. The study also determines:

the presence of blood clots in the uterine cavity;
pieces of placenta or fetal membranes;
Is organ involution occurring normally?
other complications developing in the cavity;
condition of other abdominal organs.

But after a cesarean section on the third day, an ultrasound will be uninformative regarding the size of the uterus. The operation slows down its return to normal. The uterus contracts only on the 10th day. But the risk of bleeding and endometritis is very high. For this reason, research is very important.

When should an ultrasound be done after childbirth?

A control ultrasound is done 3–4 days after birth before being discharged from the hospital. If postpartum complications are determined or remnants of fetal membranes are detected in the uterine cavity, appropriate treatment is carried out, and then a repeat ultrasound is prescribed approximately 8 days after discharge.

If postpartum recovery is going well, it is advisable to re-examine the doctor and study 8 weeks after birth. After a caesarean section, a follow-up ultrasound examination should be carried out a couple of weeks later.

Women who have not had an ultrasound scan during the postpartum period should have it done as soon as possible. This is especially important for those who are at risk.

What are the indications for ultrasound?

Urgent implementation is required in the following cases:

increased secretion of blood clots;
the temperature has increased;
pain appeared near the postoperative suture;
Liquid is oozing from the seam, and it is red and swollen;
there is a suspicion of an inflammatory process in the uterus.