{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T14:35:13Z","timestamp":1791815713051,"version":"4.3.4"},"reference-count":20,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Key Research and Development Program of China","award":["No. 2021YFC2009100"],"award-info":[{"award-number":["No. 2021YFC2009100"]}]},{"name":"Research Projects of Sichuan Science and Technology Department","award":["2023YFQ0070"],"award-info":[{"award-number":["2023YFQ0070"]}]},{"name":"Key Research Projects of Sichuan Science and Technology Department","award":["2023YFG0128"],"award-info":[{"award-number":["2023YFG0128"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Short-term poor uterine involution manifests as uterine contraction weakness. This is one of the important causes of postpartum hemorrhage, posing a serious threat to the mother\u2019s life and safety. The study aims to investigate whether low-intensity focused ultrasound (LIFUS) can effectively shorten lochia duration, alleviate postpartum complications, and accelerate uterine involution compared with the sham treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A multicenter, concealed, randomized, blinded, and sham-controlled clinical trial was conducted across three medical centers involving 176 subjects, utilizing a parallel group design. Enrollment occurred between October 2019 and September 2020, with a 42-day follow-up period. Participants meeting the inclusion and exclusion criteria based on normal prenatal examinations were randomly divided into the LIFUS group or the sham operation group via computer-generated randomization. Patients in the LIFUS group received usual care with the LIFUS protocol, wherein a LIFUS signal was transmitted to the uterine site through coupling gel, or sham treatment, where no low-intensity ultrasound signal output was emitted. The primary outcome, lochia duration, was assessed via weekly telephonic follow-ups post-discharge. The involution of the uterus, measured by uterine fundus height, served as the secondary outcome.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Among the 256 subjects screened for eligibility, 176 subjects were enrolled and randomly assigned to either the LIFUS group (n = 88) or the Sham group (n = 88). Data on the height of the uterine fundus were obtained from all the patients, with 696 out of 704 measurements (99%) successfully recorded. Overall, a statistically significant difference was noted in time to lochia termination (hazard ratio: 2.65; 95% confidence interval [CI]: 1.82\u20133.85; <jats:italic>P<\/jats:italic> &lt; 0.001). The decline in fundal height exhibited notable discrepancies between the two groups following the second treatment session (mean difference: \u22121.74; 95% CI: \u22121.23 to \u22122.25; P &lt; 0.001) and the third treatment session (mean difference: \u22123.26; 95% CI: \u22122.74 to \u22123.78; <jats:italic>P<\/jats:italic> &lt; 0.001) after delivery. None of the subjects had any adverse reactions, such as skin damage or allergies during the treatment.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This study found that LIFUS treatment can promote uterine involution and abbreviate the duration of postpartum lochia. Ultrasound emerges as a safe and effective intervention, poised to address further clinical inquiries in the domain of postpartum rehabilitation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0301825","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T17:30:01Z","timestamp":1714498201000},"page":"e0301825","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effect of low-intensity focused ultrasound therapy on postpartum uterine involution in puerperal women: A randomized controlled 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