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UTERINE SUBINVOLUTION

Uterine subinvolution is a slowing of the process of involution or shrinking of the uterus. Subinvolution is a medical condition in which after childbirth, the uterus does not return to its normal size. Definition 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. a. Causes. Endometritis, retained placental fragments, pelvic infection, and uterine fibroids may cause uterine subinvolution. b. Signs and Symptoms. (1) Prolonged lochial flow. (2) Profuse vaginal bleeding. (3) Large, flabby uterus. c. Medical Treatment. (1) Administration of oxytocic medication to improve uterine muscle tone. Oxytocic medication includes (a) Methergine-a drug of choice since it can be given by mouth. (b) Pitocin. (c) Ergotrate. (2) Dilation and curettage (D&C) to remove any placental fragments. (3) Antimicrobial therapy for endometritis. d. Nursing Interventions. (1) Early ambulation postpartum. (2) Daily evaluation of fundal height to document involution.

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