How to determine the recovery of uterine adnexa during postpartum physical examination

The recovery of postpartum uterine adnexa can be comprehensively judged through clinical symptoms, gynecological examinations, ultrasound examinations, and other methods. The main indicators include lochia discharge, uterine contraction status, ultrasound imaging evaluation, hormone level detection, pelvic floor muscle function examination, etc.

1. Discharge of lochia

Normal lochia gradually changes from bloody to serous and eventually turns white within 4-6 weeks postpartum. If bloody lochia lasts for more than 3 weeks, or if symptoms such as lochia odor and fever occur, it may indicate incomplete uterine involution or infection. It is recommended to observe daily changes in the color, odor, and amount of lochia to maintain cleanliness of the perineum.

2. Uterine Contraction Status

After childbirth, the uterus should descend 1-2 centimeters per day and should descend into the pelvis within 10-14 days. Doctors can determine the height and hardness of the uterine fundus through palpation. If the texture of the uterus is soft and the descent of the fundus is slow, it is necessary to be alert to uterine atony. breastfeeding can promote the secretion of oxytocin and assist in uterine contractions.

3. Ultrasound Imaging Evaluation

Transvaginal ultrasound can accurately measure uterine size, endometrial thickness, and adnexal area. At 6 weeks postpartum, the uterus should return to its pre pregnancy state, and the thickness of the endometrium is usually less than 10 millimeters. Further treatment is required when residual uterine cavity, blood accumulation, or adnexal mass is detected by ultrasound.

4. Hormone level testing

Blood HCG levels should decrease to normal non pregnancy levels at 2 weeks postpartum. Continuously elevated HCG may indicate placental residue or gestational trophoblastic disease. Six tests of sex hormones can evaluate the recovery of ovarian function, and lactating women may experience physiological amenorrhea.

5. Pelvic floor muscle function examination

Muscle contraction strength is evaluated through perineal muscle strength testing or pelvic floor electromyography. When muscle strength is found to be ≤ level 3 during postpartum 42 day examination, Kegel exercise rehabilitation may be necessary. Individuals with combined stress urinary incontinence or organ prolapse need to develop individualized pelvic floor rehabilitation plans. A comprehensive physical examination should be completed 42 days after delivery, including basic tests such as blood routine, urine routine, and vaginal discharge routine. Persisting in breastfeeding can help with uterine involution and avoid premature heavy physical labor. If symptoms such as abnormal vaginal bleeding, lower abdominal pain, or fever occur, seek medical attention promptly. According to the recovery situation, the doctor will guide the appropriate contraceptive method and follow-up examination time.