1. IMÁGENES EN EL
PUERPERIO
DRALLANDA TERREROS
VILA

2. PUERPERIO NORMAL
 Periodo Temprano  Eliminación loquios
(Primeras 2 sem) (14-21días)
 Periodo Tardío  Involución uterina
(Segunda 2 sem)

3. METODOLOGIA ESTUDIO
ECOGRAFIA TC - IRM
 Evaluacióninicial  Para casos más severos o de
mayor complejidad
1)Suprapúbico:
(Primeras2sem).
2)Endovaginal
(Puerperiotardío).

4. HALLAZGOS NORMALES
Al inicio:
 Útero alargado
 Masas o material ecogénicas con componente sólido y/o líquido en cavidad endometrial.
 Gas intrauterino
Intermedio(1-2sem):
 Útero reducido
 Escaso material ecogénico intrauterino con o sin gas
Tardío (> 14-21 d)
 Tamaño uterino normal
 Endometrio ecogénico lineal inactivo (hipoestrogenismo fisiológico)

5. UTERO PUERPERAL
NORMAL

6. CUANDO SE EVALUA POR IMAGENES
 Fiebre persistente / refractaria  Endometritis
 Hemorragia vaginal inmediata  Retención tejido placentario
/ tardía
 Atonía uterina
 Dolor pélvico / masa palpable
 Trombosis vena ovárica
 Abscesos / Hematomas
extrauterinas

7. ENDOMETRITIS
CT scan of the pelvis demonstrates an enlarged postpartum
uterus with an endometrial cavity expanded
by fluid, debris, and a moderate amount of air.

8. RPC
Sagittal sonogram shows echogenic mass (arrowheads)
expanding endometrium with residual placental
calcifications (arrow)
RPC
Calcifications. US image shows echogenic material
with posterior acoustic shadowing (arrow)

9. RPC
Valoración doppler, demostración
flujo arterial abundante con baja
resistencia

10. RPC. (a) US image shows echogenic material within the endometrial canal (arrows). (b) Color
Doppler US image (shown in black and white) demonstrates low-resistance arterial flow within
RPOC. Peak systolic velocity was
22 cm/sec.

11. TROMBOSIS VENA OVARICA
Sequential axial enhanced CT images show postpartum uterus
(U), enlarged heterogeneous ovary (arrow, A), dilated tortuous
right ovarian vein and partial thrombosis in pararenal inferior
vena cava (arrow)

12. ATONIA UTERINA
Postpartum hemorrhage caused by uterine atony after
vaginal delivery.
Contrast-enhanced CT scans at level of uterine body show
focal contrast extravasation (arrows)

13. ABCESOS PUERPERALES
Sagittal (a) and axial (b) contrast-enhanced CT scans demonstrate a
fluid collection with pockets of air (arrow in a, straight arrow in b)
extending from the surgical wound (curved arrow in b). The abscess is
distinct from the endometrial cavity (arrowhead).

14. Axial fat-suppressed T2-weighted MR images obtained at
the level of the fundus of the uterus (a) and the body of the
uterus (b) show multiple small, markedly hyperintense areas
(arrows) surrounded by slightly hyperintense regions
adjacent to the uterus.