Ultrasound and Doppler assessment of uterus during puerperium after normal delivery

To describe the biometric and morphological characteristics of the uterus through ultrasound (US) and Doppler on the uterine arteries in the initial and late puerperium after normal delivery.

This was a prospective longitudinal study on full-term singleton pregnancies without complications. The patients were divided into two groups: 31 primiparous and 28 multiparous women. Two US exams were carried out with Doppler evaluation: firstly, within the initial 48 h; and secondly, between 31 and 50 days after childbirth. The US assessed the position and biometry of the uterus, appearance of the myometrium, measurement and content of the uterine cavity, and Doppler velocimetry indices of uterine arteries. To compare the groups at the two times, the paired Student t-test, Fisher's exact test and chi-square test were used.

In the initial puerperium, the position of the uterus was retroversion (98.3%); the appearance of the myometrium was heterogeneous (96.6%); the uterine cavity was filled with some type of material (72.9%). After the 30th day, a position was anteversion (74.6%); the appearance of the myometrium was homogeneous (91.5%); and the uterine cavity was empty (81.3%). There was an evolution in the pulsatility index between the two US exams, with an increase of 52.03% among the primiparous and 53.13% among the multiparous for the right uterine artery.

Significant changes were observed in the morphological and biometric characteristics of the uteruses evaluated through US, as well as in the uterine arteries Doppler, between the initial and late puerperium.