Subinvolution

Definition
 It is a medical condition in which after childbirth, the uterus does not return to its
normal size.
 4-6 weeks postpartal visit uterus is still enlarged and soft
Signs and Symptoms
 Abnormal lochial discharge either excessive or prolonged
 Irregular or excessive uterine bleeding
 Pelvic pain and heaviness
 The uterine height is greater than normal
 Fatigue
Causes
1. Long labor 6. Retained placenta
2. Anesthesia 7. Grand multiparity
3. Difficult delivery
4. Overdistension of uterus as in twins and hydramnios
5. Maternal infection
Management
Medical Management
 Exploration of the uterus in retained products
 Dilation of the cervix and curettage to remove fragments of the placenta from the
uterine wall
 Antibiotics for infection
 Methergine to maintain firm uterine contractions
 Administration of Methylergonovine 0.2 4 times a day
 Administration of Oxytocin
Nursing Management
 Teach the normal changes to expect
 Report abnormal pattern
o Fever, pain, persistent red lochia
o Foul-smelling vaginal discharge
 Comfort measures
 Prepare for possible surgical intervention
 Explain medications prescribed

Caballero, Kistlerzane
De Aro, Resmer Joseph