Sub-Involution - Abnormal Puerperium

Sub-Involution

This is defined as a delay of the uterus to return to their pre-gravid state, usually due to retained products of conception and infection.

Causes

·              Anything interfering with proper contraction of the uterus e.g. full bladder and rectum and retained product.

·              Local uterine infection

·              Presence of uterine fibroid

·              Grande multiparity

Signs And Symptoms

·              Bulky and soft uterus

·              Lochia are profuse and reddish brown.

·              The fundal height remains stationary for a few days.

Management

The midwife should palpate the uterus to exclude tenderness which may be due to infection. The suprapubic area should be percussed to exclude full bladder. Constipation should also be excluded; early ambulation of the patient should be encouraged. The doctor may order a course of ergomotrine 0.5mg x 3 days orally analgesics e.g. panadol 2 tablets when necessary. The lochia should also be closely watched.

Nursing care

This includes physical care, psychological care, asepsis, exercises, adequate breast feeding, good diet.