Uterine subinvolution is a slowing of the process of involution or shrinking of the uterus.

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®.

Brookside Associates Note: Currently, many medical centers would include misoprostol(Cytotec®) in this list.

(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.