Sonographic Evaluation of Uterine Dimensions in Postpartum Women of Reproductive Age-Study from Enugu, Southeast Nigeria

Abstract

Introduction: Uterine involution, a physiological process in which the uterus reverts to prepregnant size, occurs during puerperium. The latter is a time of substantial maternal risk. Ultrasound is considered the most appropriate tool in monitoring the progression of uterine involution because it is cheap, convenient and repeatable with no radiation risk. Aim: To sonographically evaluate the involution of the uterus and uterine cavity in postpartum women in Enugu, Nigeria. Materials and Methods: This was a prospective longitudinal cohort study on 400 postpartum women at the University of Nigeria Teaching Hospital, Enugu, Nigeria. Transabdominal ultrasonography to measure uterine dimensions was done on day 1, day 3 and day 42 of puerperium using a 3.5-5 MHz curvilinear probe of a portable ALOKA ultrasound machine. Statistical analysis was done with the Statistical Package for Social Sciences (SPSS) software version 20.0. The uterine dimensions were expressed as mean±standard deviation and student's t-test analysis was used to compare the values for day 1, day 3 and day 42 of puerperium. Regression analysis was carried out to measure the relationship between uterine measurements on days 1, 3 and 42. A p-value of <0.05 was considered statistically significant. Results: The mean longitudinal, anteroposterior and transverse diameters of the uterus at day 1 were 14.51 cm, 8.54 cm and 10.97 cm, respectively. The corresponding values for day 42 were 8.27 cm, 4.78 cm, and 6.22 cm. The uterine diameters decreased significantly as puerperium advanced (p<0.001). The mean uterine cavity diameters also decreased significantly as puerperium advanced (p<0.001). There was significant regression between longitudinal diameters of both uterus and uterine cavity on days 1 and 3 but not between days 3 and 42. Conclusion: This study has established a normal range of diameters for the uterus and uterine cavity on day 1, day 3 and day 42 of puerperium. It can serve as reference data for further studies in the study area.