Ultrasound evaluation of the postpartum endometrial cavity

To establish normal ultrasonographic findings for the postpartum uterus.

We performed a prospective cohort study on women delivering during the study period. Ultrasounds were performed abdominally within 48 hours of delivery. Measurements of the endometrial cavity and remarkable findings such as echogenic debris or uterine abnormalities were documented. Additionally, we followed patients during their hospital course for bleeding complications and the need for medical or surgical treatment of such complications.

Of the 114 patients enrolled during our study period, 79 (69%) delivered vaginally and 35 (31%) delivered by cesarean; 39 (34%) were primiparous and 75 (66%) were multiparous. The mean endometrial cavity measurement was 1.15 ± 0.3 cm. There was no difference in endometrial cavity when evaluating parity (p = 0.26) or vaginal versus cesarean delivery (p = 0.8). Echogenic material in the endometrial cavity was noted in 22 (19%) of the 114 patients. The presence of echogenic material was significantly higher following vaginal delivery (p = 0.008). None of the patients had a complication in the postpartum period.

Air endometrial cavity measurement of < 1.2 cm after a vaginal or cesarean delivery should be considered normal. Presence of echogenic material in the endometrial cavity appears to be a normal variant.