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Vol. 63. Issue 1.
Pages 22-31 (January - February 2021)
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Vol. 63. Issue 1.
Pages 22-31 (January - February 2021)
Radiology through images
DOI: 10.1016/j.rxeng.2020.08.001
Puerperal complications: Pathophysiological mechanisms and main imaging findings
Complicaciones del puerperio: mecanismos fisiopatológicos y principales hallazgos radiológicos asociados
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J. García Prieto
Corresponding author
juliagprieto@gmail.com

Corresponding author.
, J. Alonso Sánchez, E. Martínez Chamorro, L. Ibáñez Sanz, S. Borruel Nacenta
Hospital Universitario 12 de Octubre, Madrid, Spain
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Abstract
Objective

Puerperium is the period during which the physiological changes that have taken place during pregnancy revert and the uterus involutes until it reaches its normal size. This is a period of intense systemic changes, and diagnosing complications in this period is a challenge for both gynecologists and radiologists.

This paper reviews the complications that can occur during puerperium, classifying them according to the pathophysiological mechanisms involved: the prothrombotic state, hemodynamic and hormonal changes, rapid uterine growth, changes associated with endothelial damage (preeclampsia, eclampsia, and HELLP syndrome), and postoperative complications in patients undergoing cesarean sections.

Conclusion

Puerperal complications represent a diagnostic challenge. Understanding the pathophysiological mechanisms underlying these complications is fundamental for choosing the most appropriate imaging technique to ensure the correct diagnosis in each case.

Keywords:
Computed tomography
Puerperium
Thrombosis
Eclampsia
Endometritis
Resumen
Objetivo

El puerperio es el periodo en el que los cambios fisiológicos que han tenido lugar durante el embarazo revierten y el útero involuciona hasta recuperar su tamaño normal. Se trata de un periodo de intensos cambios sistémicos, y el diagnóstico de las complicaciones asociadas constituye un reto tanto para el ginecólogo como para el radiólogo.

En este trabajo se revisan las complicaciones que pueden acontecer, y se clasifican en función de su mecanismo fisiopatológico: el estado protrombótico, los cambios hemodinámicos y hormonales, el rápido crecimiento uterino, las alteraciones asociadas al daño endotelial (preeclampsia, eclampsia y síndrome de HELLP) y las complicaciones posquirúrgicas de la cesárea.

Conclusión

Las complicaciones del puerperio son un reto diagnóstico. Comprender el mecanismo fisiopatológico subyacente es fundamental para el diagnóstico y la elección de la técnica de imagen más apropiada en cada caso.

Palabras clave:
Tomografía computarizada
Puerperio
Trombosis
Eclampsia
Endometritis

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