What tests are needed for postpartum abdominal cramps?

  Pelvic stasis syndrome is characterized by lumbosacral pain and postpartum abdominal cramps, radiating to the lower extremities and aggravated by prolonged standing and exertion. PelvicCongestionSyndrome, also known as OvarianVeinSyndrome, is one of the most important causes of gynecological pelvic pain, because its symptoms are widespread, and the patient’s conscious symptoms and objective examination often do not match, and are often confused with chronic pelvic inflammatory disease in terms of physical signs. The patient’s symptoms are often confused with those of chronic pelvic inflammatory disease. The pelvic stasis syndrome has been documented for a long time. However, it has been debated whether the clinical manifestations described above are a unique pathology or a common phenomenon caused by certain diseases.  What tests are needed for postpartum abdominal cramps?  1.Vaginal ultrasound color Doppler examination.  2.Laparoscopy is the same as open surgery, but due to the elevation of the pelvis, the varicose veins are not always visible in some cases, but can be differentiated from other lesions such as inflammation.  3.Spiral CT has recently been reported in the literature that spiral CT is a non-invasive and effective method to diagnose pelvic venous stasis syndrome. Spiral CT with arterial images is taken when the patient is breathing deeply, because deep breathing causes an increase in abdominal venous pressure, which leads to retrograde renal venous blood filling the varicose veins around the uterus and ovaries, and varicose veins with a diameter >5mm can be visualized. Conventional CT only shows some dilated veins, which are not related to pelvic venous stasis syndrome.  4.Pelvic venography pelvic venography is to inject contrast agent into the myometrium of uterine cavity to visualize uterine vein, ovarian vein and part of vaginal vein and internal iliac vein, and take pictures continuously at certain time interval to understand the time of pelvic blood (mainly uterine vein and ovarian vein) flowing out of pelvic cavity, as a method to assist in diagnosing pelvic stasis syndrome. In normal pelvic venous blood flow, the contrast agent usually flows out of the pelvic cavity completely within 20s; while in pelvic stasis sign, the venous reflux rate becomes significantly slower and the contrast agent flows out of the pelvic cavity, which takes more than 20s.  5.Radionuclide pelvic blood pool scan is used to diagnose pelvic venous stasis after tubal ligation. The principle is that when the pelvic veins are stagnant, the local veins are varicose and the blood is stagnant forming a “blood pool”, thus obtaining a scan image of the concentration of radioactive readable nuclides.  6.Position experiment. When lying on the chest and knees, the pelvic vein pressure decreases, and there is no lower abdominal pain or slight pain, if immediately changed to sit backward on the heel of the buttocks, keeping the position slightly higher than the abdomen, due to the tight groin flexion, the blood flow from the external iliac artery to the femoral artery is blocked, thus the blood flow from the internal iliac artery increases, which makes the pelvic vein pressure rise and produces stasis, and the lower abdominal pain returns to the chest and knee position, the symptoms are reduced, which is called “postural experiment Positive”.