Subinvolution of the uterus refers to the delayed return of the uterus to its pre-pregnancy size and condition after childbirth.



Normal Involution



After delivery, the uterus gradually shrinks back to its non-pregnant size.



Typically takes about 6 weeks postpartum.





Subinvolution



This occurs when that process is slower than normal.



Causes



Retained placental fragments



Infection (endometritis)



Uterine atony (lack of muscle tone)



Fibroids or other uterine abnormalities





Signs and Symptoms



Prolonged lochia (postpartum vaginal discharge), especially if it's heavy or foul-smelling



Uterus larger and softer than expected on exam



Pelvic pain or tenderness



Possibly fever if infection is present





Diagnosis



Clinical exam (uterine size)



Ultrasound (to detect retained products)



Blood tests (if infection is suspected)





Treatment



Ergometrine or oxytocin to promote uterine contractions



Antibiotics if infection is present



Surgical removal of retained products if necessary.



#diagrame