Siegfried Andre C.

Avila BSN N22

Post-partum: Assessment, Care, Complications

According to the video, the postpartum phase, commonly known as the puerperium, begins immediately
after the baby and placenta are delivered and lasts 6-8 weeks. Physiologic uterine alterations during puerperium
can overlap with postpartum problems, making imaging interpretation and diagnosis problematic. Obstetric and
non-obstetric postpartum problems are a significant cause of morbidity and mortality in women of reproductive
age, and the radiologist plays an important role in assessing these entities, which frequently necessitate a
multimodality imaging approach.

The spectrum of postpartum complications ranges from relatively self-limiting to life-threatening

conditions that can be divided into six categories: infectious conditions (endometritis), thrombotic complications
(eg, deep vein thrombosis, ovarian vein thrombophlebitis, HELLP [hemolysis, elevated liver enzymes, and low
platelet count] syndrome, or cerebral sinus thrombosis), hemorrhagic conditions (e.g., uterine atony, trauma of the
lower portion of the genital tract, retained products of conception, uterine artery arteriovenous malformations, or
uterine artery pseudoaneurysm), cesarean delivery–related complications (e.g., bladder flap hematoma, subfascial
hematoma, rectus sheath hematoma, abscess formation, uterine dehiscence, uterine rupture, vesicovaginal fistula,
or abdominal wall endometriosis), iatrogenic conditions (e.g., uterine perforation), and no obstetric complications
(e.g., acute cholecystitis, acute appendicitis, uterine fibroid degeneration, renal cortical necrosis, pyelonephritis,
posterior reversible encephalopathy syndrome, or pituitary gland apoplexy).

Knowing the specifics of the anatomical and pathophysiologic characteristics of the postpartum period is
essential for making an appropriate diagnosis when difficulties occur since it is a well-defined physiologic state.
Correct distinction of the significantly overlapping normal and pathological postpartum radiologic findings is
made possible by acquaintance with the typical look of the postpartum anatomy as it is viewed with various
imaging methods. These findings are frequently nearly indistinguishable from one another, making the patient's
clinical history the distinguishing factor. The foundation of a precise diagnosis and appropriate treatment is
communication with the patient. The most frequent cause of postpartum fever, endometritis, is a crucial idea.
After cesarean delivery, the risk is very high. Endometrial gas can be a common observation for up to three weeks
following delivery, which is a noteworthy aspect of postpartum pictures that do not always suggest infection. It is
critical to differentiate between subfascial hematomas and bladder flaps since surgical therapy may or may not
call for peritoneal incision. It can be difficult to distinguish between uterine dehiscence and rupture. While
attempting to determine if the serosal layer is healthy or damaged, it is important to keep in mind that the most
dangerous uterine rupture should be feared if a significant subfascial hematoma, a significant volume of fluid, or a
hemoperitoneum are present. Other tests, especially radiology is crucial for assessing postpartum problems, and
because many disorders might present clinically in unexpected ways, immediate imaging may be required. To
make the right diagnosis and administer the proper and prompt therapy, one must be aware of both frequent and
unusual puerperal problems as well as their distinctive imaging findings.