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Understanding Subinvolution After Childbirth

Subinvolution occurs when the uterus fails to return to its normal non-pregnant size after childbirth. It can be caused by retained placental fragments, endometritis, or other issues interfering with uterine contraction like fibroids. Symptoms include abnormal or prolonged bleeding and lochial discharge. Treatment focuses on antibiotics for infection, exploration for retained products, and drugs like oxytocin to aid the involution process.

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Joanne Bernadette Aguilar
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287 views8 pages

Understanding Subinvolution After Childbirth

Subinvolution occurs when the uterus fails to return to its normal non-pregnant size after childbirth. It can be caused by retained placental fragments, endometritis, or other issues interfering with uterine contraction like fibroids. Symptoms include abnormal or prolonged bleeding and lochial discharge. Treatment focuses on antibiotics for infection, exploration for retained products, and drugs like oxytocin to aid the involution process.

Uploaded by

Joanne Bernadette Aguilar
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd

SUBINVOLUTION

by: Joanne Bernadette C. Aguilar


 Subinvolution
 Is the incomplete return of the uterus to its prepregnant size and shape.
 Is a medical condition in which after childbirth, the uterus does not return to
its normal size
 When the involution 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.
 Subinvolution may result from a small retained placental fragment, a mild
endometritis(infection of the endometrium),or an accompanying problem such
as a uterine myoma that is interfering with complete contraction
 Signs and Symptoms
 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. 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.
 Assessment
 The uterus is still enlarged and soft
 Lochial discharge usually is still present
 Causes
 - Predisposing factors :
 Grand multiparity
 Overdistension of uterus as in twins and hydramnios
 Ill maternal health
 Caesarean section
 Uterine prolapse
 Retroversion after the uterus becomes pelvic organ
 Uterine fibroid
 - Aggravating factors

 Retained products of conception

 Uterine sepsis, endometritis

 - Factors

 Persistent lochia/fresh bleeding

 Long labor

 Anesthesia

 Full bladder

 Difficult delivery

 Retained placenta

 Maternal infection
 Nursing Management
 Oral Antibiotics in endometritis
 Exploration of the uterus in retained products
 Ergometrine so often prescribed to enhance the involution process by
reducing the blood flow of the uterus is of no value in prophylaxis.
 Oral administration of methylergonovine 0.2 mg 4 times daily
 Administer oxytocin

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