{{Short description, Medical condition after childbirthSubinvolution is a medical condition in which after

childbirth Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million births globall ...

, the

uterus The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The uter ...

does not return to its normal size.

Presentation

Symptoms

The condition may be asymptomatic. The predominant symptoms are: * Abnormal lochial discharge either excessive or prolonged * Irregular or at times excessive uterine bleeding * Irregular cramp like pain is cases of retained products or rise of temperature in sepsis

Signs

# The uterine height is greater than the normal for the particular day of

puerperium The postpartum (or postnatal) period begins after childbirth and is typically considered to end within 6 weeks as the mother's body, including hormone levels and uterus size, returns to a non-pregnant state. The terms puerperium, puerperal perio ...

. Normal puerperal uterus may be displaced by a full bladder or a loaded rectum. It feels boggy and softer upon palpation. # Presence of features responsible for subinvolution may be evident.

Causes

Predisposing factors

# Grand

multiparity In biology and medicine, human medicine, gravidity and parity are the number of times a woman is or has been pregnant (gravidity) and carried the pregnancies to a viable gestational age (parity). These terms are usually coupled, sometimes with add ...

# Overdistension of uterus as in twins and hydramnios # Ill maternal health #

Caesarean section Caesarean section, also known as C-section or caesarean delivery, is the surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen, often performed because vaginal delivery would put the baby or mo ...

Uterine prolapse Uterine prolapse is when the uterus descends towards or through the opening of the vagina. Symptoms may include vaginal fullness, pain with sex, trouble urinating, urinary incontinence, and constipation. Often it gets worse over time. Low back pa ...

Retroversion Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...

after the uterus becomes pelvic organ #

Uterine fibroid Uterine fibroids, also known as uterine leiomyomas or fibroids, are benign smooth muscle tumors of the uterus. Most women with fibroids have no symptoms while others may have painful or heavy periods. If large enough, they may push on the bl ...

Aggravating factors

* Retained products of conception * Uterine sepsis, endometritis

Factors

* Persistent

lochia In the field of obstetrics, lochia is the vaginal discharge after giving birth, containing blood, mucus, and uterine tissue. Lochia discharge typically continues for four to eight weeks after childbirth, a time known as the postpartum period or pue ...

/fresh bleeding * Long labor *

Anesthesia Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), ...

* Full bladder * Difficult delivery * Retained placenta * Maternal

infection An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...

Diagnosis

Definition

When the

involution Involution may refer to: * Involute, a construction in the differential geometry of curves * '' Agricultural Involution: The Processes of Ecological Change in Indonesia'', a 1963 study of intensification of production through increased labour inpu ...

is impaired or retarded it is called subinvolution. The uterus is the most common organ affected by subinvolution. As it is the most accessible organ to be measured per abdomen, the uterine involution is considered clinically as an index to assess subinvolution.

Management

* Antibiotics in endometritis * Exploration of the uterus in retained products *Pessary in prolapse or retroversion. * Ergometrine so often prescribed to enhance the involution process by reducing the blood flow of the uterus is of no value in prophylaxis.

References

*DC Dutta Textbook of obstetrics sixth edition Obstetrics Uterus