Is Postpartum Uterine Involution Impacted by Instrumental or Operative Procedures? Ultrasound Study

Objectives: Practitioners are continuously concerned with thedifferences between the normal puerperium and the uterine involution afteroperated deliveries. This prospective observational study pays attention to theuterine involution period after the instrumental or operative delivery andcompares the results with those observed in uncomplicated labour. Methods: Over two postpartum months 66 women after normal(48) and complicated (18) labour were examined for repeated uterine parameters.The analysis was performed using SPSS version 21. Results: There was no statistically significant differencebetween the median uterine size parameters or the uterine artery indices afterthe normal delivery and instrumental/operative uterine manipulations during theinvolution period, except for a faster declining trend observed in anteroposteriordiameter within the first month after normal labour. The diastolic notch wasmore frequent in early puerperium after complicated labor, but less frequentlater. The diastolic notch did not appear in all the postpartum women even twomonths after labour. There was evidence of more frequent gas detected in thepathological rather than in the physiological group. Conclusion: Postpartum uterine involution is not impacted byinstrumental or operative procedures. After complicated labour gas appearanceis more common, but it does not necessarily indicate the presence of endometritisor retained placental tissues.