Postpartum subinvolution of the uterus: clinical, sonographic and biochemical aspects

A prospective study was conducted in 197 patients (mean age 25.0 ± 2.4 years). Established clinical and laboratory-instrumental criteria for various options for postpartum subinvolution of the uterus:
1) subinvolution without clinical signs of an infectious and inflammatory process – leukocytosis up to 10×10⁹/l, the number of stab neutrophils 3–4 %, ESR up to 20 mm/h, PCT less than 0,05 ng/ml, hsCRP level less than 10 mg/l, LII less than 1 unit, PLA2 activity 2, 5–4 IU/l, IR of uterine arteries less than 0.5; expansion of the uterine cavity up to 15 mm according to ultrasound; uterine tone less than 5.4 mHg;
2) subinvolution with minor clinical signs of inflammation – leukocytosis 10–11×10⁹/l, the number of stab neutrophils 5–7 %, ESR 20–30 mm/h, PCT 0,05–1,5 ng/ml, the level of hsCRP 10–20 mg/l, LII – 1–3 units, activity PLA2 4–7.0 IU/l, IR of uterine arteries less than 0.5, expansion of the uterine cavity 15–20 mm; uterine tone less than 5.4 mHg;
3) subinvolution complicated by HPE – leukocytosis 12×10⁹/l or more, the number of stab neutrophils 8 % or more, ESR – more than 30 mm/h, PCT more than 1,5 ng/ml, hsCRP level more than 20 mg/l, LII more than 3 units, PLA2 activity more than 7.0 IU/l, IR of the uterine arteries is less than 0.5, the expansion of the uterine cavity is more than 20 m, uterine tone less than 5.4 mHg.
2. A strong inverse relationship was found between uterine tone and uterine cavity size (correlation coefficient r = –0.9751; p < 0.001; 95 % confidence interval) in patients with SCI.
3. A decrease in the index of resistance of the uterine arteries to 0.47 ± 0.02 c. u. was established (p = 0.022) in a strong direct associative relationship with the size of the uterine cavity (correlation coefficient r = 0.93712; p = 0.001; 95 % confidence interval).

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