Changes in uterine size after vaginal delivery and cesarean section determined by vaginal sonography in the puerperium
Changes in uterine size after vaginal delivery and cesarean section determined by vaginal sonography in the puerperium
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DOI：
10.1007/s004040050253
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发表时间：
1999-11-01
影响因子：
2.6
通讯作者：
Fujimoto, S
中科院分区：
文献类型：
--
作者：
Negishi, H;Kishida, T;Fujimoto, S
关于产后三个月内子宫的产后变化报道很少。本研究的目的是评估阴道分娩后妇女（n=262-351）和剖宫产后妇女（n=64-82）的子宫形态学变化，并评估母乳喂养和产次之间的关系，以及产后1和3个月阴道超声测量的子宫复旧。阴道分娩组与剖宫产组的产次无显著差异。一个月时子宫的长度（7.93+/-1.16 cm，平均值+/-SD）和3个月（7.03+/- 1.19 cm）和3个月时的子宫宽度剖腹产组分娩后的血压（3.83+/-0.94cm）大于经阴道组（分别为7.64+/-1.03 cm、6.65+/-0.99 cm、3.57+/-0.62 cm）。增加产妇产次与产后一个月子宫大小稍大有关。产后3个月时，母乳喂养率为80%或以上的妇女子宫长度为6.35 ± 0.85厘米，比母乳喂养率为20%或以下的妇女子宫长度短7.03 ± 1.04厘米。产后3个月时，母乳喂养率为80%或以上的妇女子宫体宽度为3.32 ± 0.45 cm，小于母乳喂养率为20%或以下的妇女子宫体宽度为3.87 ± 0.66 cm。对产次、剖宫产史、产后1个月、3个月母乳喂养率、产后3个月月经恢复情况进行逐步回归和多元回归分析，发现产后1个月子宫大小与剖宫产有关，产后3个月子宫大小与母乳喂养率关系最密切。提示子宫复旧与产后1月、3月分娩方式、产后3月喂养方式、月经恢复及产次有关。母乳喂养率与产后3个月子宫大小有关。
There have been few reports on postpartum changes in the uterus during the three months after delivery. The aim of this study was to evaluate uterine morphological changes in women after vaginal delivery (n=262-351) and in women after cesarean section (n=64-82) and to evaluate the relation between breastfeeding and parity, and uterine involution at 1 and 3 months postpartum measured by vaginal ultrasonography. There were no significant differences in parity between the vaginal delivery group and the cesarean section group. The length of the uterus at one month (7.93+/-1.16 cm, mean+/-SD) and, three months (7.03+/- 1.19 cm) and the width of the uterus at three months (3.83+/-0.94 cm) after delivery in the cesarean section group were greater than in the transvaginal group (7.64+/-1.03 cm, 6.65+/-0.99 cm, 3.57+/-0.62 cm, respective ly). Increasing maternal parity was associated slightly with larger uterine size at one month post partum. The length of the uterus of women with a breast-feeding rate of 80% or more per day was 6.35+/-0.85 cm, and shorter than in women with a rate of 20% or less 7.03+/-1.04 cm, at three months after delivery. The width of the uterine body of women with a breast-feeding rate of 80%, or more per day was 3.32+/-0.45 cm, and shorter than in women with a rate of 20% or less 3.87+/-0.66 cm, at 3 months after delivery. Stepwise regression and multiple regression analysis among parity, the history of cesarean section, the breast-feeding rate at one and three months after the delivery, and the restoration of the menses at three months after the delivery showed that the uterine size at one month after the delivery was related to the cesarean section and that the uterine size at three months after delivery was mostly related to the rate of breastfeeding. These results indicated that uterine involution was related to delivery mode at one and three months postpartum, feeding mode at three months postpartum the menses restoration, and parity. The rate of breastfeeding was mostly related to the uterine size at three months postpartum.