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Uterine Subinvolution

Failure of the uterus to return to its normal size after childbirth can cause delayed postpartum bleeding.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Uterine Subinvolution?

After childbirth the uterus normally shrinks about 1 cm per day and approximates its prepregnancy size by the sixth week. In subinvolution this process is delayed; the uterus remains soft, enlarged, and tender.

The most frequent causes are retained placental fragments, endometritis, fibroids, multiple pregnancy, polyhydramnios, and macrosomia. Lack of breastfeeding and limited early mobilization can also contribute.

Treatment first targets the underlying cause: ultrasound-guided curettage for retained tissue, antibiotics for infection. Uterotonic agents (oxytocin, methylergonovine) may help in subinvolution.

Symptoms

Prolonged heavy bleeding after delivery
Bright red lochia persisting beyond the fourth week
Uterus that remains large and soft
Lower abdominal tenderness
Fever and foul odor when infection is present
Fatigue and signs of anemia

Risk Factors

Retained placental tissue
History of endometritis
Multiple pregnancy and polyhydramnios
Macrosomic baby
Presence of fibroids
High parity

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Heavy bleeding still present two weeks after delivery
  • Uterine tenderness with fever
  • Clotted, foul-smelling lochia
  • Onset of dizziness and weakness
  • Inadequate uterine involution detected at routine postpartum check

Treatment Methods

01
Ultrasound assessment of the uterine cavity
02
Complete blood count and infection markers
03
Curettage for retained tissue
04
Uterotonic medications
05
Antibiotic therapy when endometritis is present
06
Iron replacement when anemia exists

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.