Superb microvascular imaging for assessment of post-cesarean myometrial blood flow from 1 to 4 weeks after operation: A preliminary study.

Purpose: To evaluate superb microvascular imaging for measuring puerperal myometrial microvascular blood flows at incisional sites following cesarean delivery.

Methods: Twenty postpartum women (singleton births) were studied: 10 with cesarean and 10 with transvaginal deliveries. All cesarean cases were first operational delivery with lower uterine incision, repaired with double-layer suture. At 1 and 4 weeks postpartum, the uterus was delineated using transvaginal ultrasonography with superb microvascular imaging. Separate regions of interest were created for anterior myometrium of the isthmus and the body. The microvascular flow profile in three circular sampling points placed in a region of interest was quantified and expressed as vascular density. The vascular density ratio of the uterine isthmus to the body was compared between one and four weeks for both groups. Wilcoxon's signed-rank test was used to assess statistical significance (set at p < 0.05).

Results: In cesarean deliveries, the vascular density ratio of the uterine isthmus to the body increased from 1 (median: 0.51, range: 0.30-0.68) to 4 weeks (0.99, 0.85-1.60), whereas no changes were noted in transvaginal deliveries.

Conclusion: Superb microvascular imaging can effectively measure myometrial microvascular blood flow recovery at cesarean incision sites, indicating its potential as a tool for monitoring postpartum wound healing.