Sub-Involution of Uterus

Subject: Midwifery III (Theory)

Overview

Sub-involution is the term used to describe a degraded or delayed involution. The uterus is the organ most frequently impacted by sub-involution. The uterine involution is used clinically as an index to evaluate subinvolution since it is the easiest organ to measure per abdomen. Overdistention of the uterus, such as in twin pregnancies and hydramnios, maternal illness, cesarean sections, uterine prolapse, retroversion once the uterus becomes a pelvic organ, and uterine fibroids are predisposing factors. The illness could not show any symptoms. For the specific day of Puerperium, the fundal height is higher than average. Retained products and blood clots must be removed after placenta delivery. By getting up early and taking care of your perineum, you can promote healthy uterine drainage during the postnatal period.

Sub-Involution of Uterus

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

Causes

Predisposing factors are:

  • Grand multiparity,
  • Over distention of uterus as in twins and hydramnios,
  • Maternal ill health ,
  • Caesarean section,
  • Prolapse of the uterus,
  • Retroversion after the uterus becomes pelvic organ,
  • Uterine fibroids.

Aggravating factors are ;

  • Retained product of conception ,
  • Uterine sepsis.

Sign and symptoms

Symptoms

  • The condition may be asymptomatic.
  • Abnormal lochia discharge either excessive or prolonged .
  • Irregular or at times excessive uterine bleeding.
  • Irregular cramp like pain in cases of retained products or rises of temperature in sepsis.

Signs

  • The fundal height is greater than the normal for the particular day of Puerperium.
  • Uterus feels boggy and softer.
  • Uterine fundus may not palpate properly.

Management

  • Retained products and blood clots must be removed after placenta delivery.
  • By getting up early and taking care of your perineum, you can promote healthy uterine drainage during the postnatal period.
  • A loaded rectum and bladder distention should be avoided.
  • Eat a nutrient-rich diet and drink lots of water.
  • If puerperal sepsis is evident, take an antibiotic.
  • Uterine exploration in retained products.
  • It might be required to use ergometrine to speed up involution by decreasing blood supply to the uterus.
Things to remember
  • When the involution is impaired or retarded it is called sub -involution.
  • The uterus is the most common organ affected in sub -involution .
  • As it is the most accessible organ to be measured per abdomen, the uterine involution is considered clinically as an index to assess subinvolution.
  • Predisposing factors are over distention of uterus as in twins and hydramnios,maternal ill health ,caesarean section, prolapse of the uterus,retroversion after the uterus becomes pelvic organ,uterine fibroids.
  • T he condition may be asymptomatic.
  • The fundal height is greater than the normal for the particular day of Puerperium. After delivery of the placenta,retained products and blood clots must be removed.
  • Facilitate well uterine drainage during the postnatal period by early ambulation and perineal care.
Questions and Answers

Predisposing factors are:

  • Great multiparity, excessive uterine distention, such as with twins or hydramnios,
  • Maternal health issues,
  • Cesarean delivery,
  • Uterine prolapse,
  • Retroversion following uterine conversion to a pelvic organ,
  • Uterine fibroids, etc.

Aggravating factors are:

  • The retained conception product,
  • Uterine septicemia.
  • Retained products and blood clots must be removed after placenta delivery.
  • By getting up early and taking care of your perineum, you can promote healthy uterine drainage during the postnatal period.
  • A loaded rectum and bladder distention should be avoided.
  • Eat a nutrient-rich diet and drink lots of water.
  • If puerperal sepsis is evident, take an antibiotic.
  • Uterine exploration in retained products.
  • It might be necessary to use ergometrine to speed up involution by decreasing blood flow to the uterus.

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