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Subinvolution: Unit: IX

The document discusses subinvolution, which is when the uterus does not fully return to its normal size after childbirth. It defines subinvolution and lists its causes such as grand multiparity or uterine sepsis. The summary also describes the signs and symptoms of subinvolution and the management approaches which include exploration of the uterus, administration of oxytocic medications, and dilation and curettage if needed.

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5K views

Subinvolution: Unit: IX

The document discusses subinvolution, which is when the uterus does not fully return to its normal size after childbirth. It defines subinvolution and lists its causes such as grand multiparity or uterine sepsis. The summary also describes the signs and symptoms of subinvolution and the management approaches which include exploration of the uterus, administration of oxytocic medications, and dilation and curettage if needed.

Uploaded by

mikegrace02
Copyright
© © All Rights Reserved
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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B.

Sc DEGREE COURSE IN NURSING (BASIC)


Midwifery and Obstetrical Nursing

Unit: IX.
Subinvolution

Dr. P. PADMAVTHI, PRINCIAPL


Objectives;
 At the end of the class the student will be able to

 Explain the definition of sub involution

 List down the causes

 Explain the signs and symptoms

 Describe the management of sub involution


Definition

• Subinvolution is a medical condition

in which after childbirth, the uterus

does not return to its normal size.

• When the involution is impaired is

called sub-involution.
Causes of sub involution .

Predisposing factors:
• Grand multiparity.
• Overdistension of uterus as in twins and hydramnios.
• Maternal ill health
• Caesarean section.
• Uterine prolapse.
• Retroversion after the uterus becomes pelvic organ.
• Uterine fibroids
Cont..
• AGGREAVATING FACTORS:

 Uterine sepsis (Endometritis)

 Retained products of conception


Signs and Symptoms

May be asymptomatic sometimes

 Abnormal Lochial Discharge : Excessive or prolonged

 Irregular at times Excessive Uterine Bleeding

 Irregular Cramp like Pain (Retained bits)

 Rise of Temperature in case of Sepsis


Cont..

• Signs

Fundal height Displaced


Fundal height Uterus feels
Bladder or
Greater than Boggy and
Loaded
Postnatal Day Softer
Rectum
MANAGEMENT

• Exploration of uterus for retained products

• Pessary in prolapse or retroversion

• Methergine to enhance involution process

• Antibiotics in case of infection

• Early ambulation postpartum.

• Daily evaluation of fundal height to document involution. ss


Cont..

 Medical Treatment.

1) Administration of oxytocic medication to improve uterine muscle tone.

2) Oxytocic medication includes


(a) Methergine - drug of choice since it can be given by mouth.

(b) Pitocin.

(c) Ergotrate.
.
Cont..

1. Dilation and curettage (D&C) to remove any placental fragments.

2. Antimicrobial therapy for endometritis.

D. Nursing Interventions.

(1) Early ambulation postpartum.

(2) Daily evaluation of fundal height to document involutio


Bibliography
o Text book of midwifery, Helen varney( CNM) MSN,Jan .M. kribes, 4 th
edition, All india publication, Pg num 1098
o A comprehensive text book of Midwifery, Annama jacob ,M.Sc (N),
9th edition, jaypee brothers publications Pg no; 449
o Text book of obstetrics, DC Dutta MMBS,DGO, 9th edition, Jaypee
brothers publication ,Pg no; 410
o Midwifery for nurses, Marie elizabeth, 2nd edition, CBS publication
,Pg no;385

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