Subinvolution of the uterus refers to the delayed return of the uterus to its pre-pregnancy size and condition after childbirth. Normal Involution After delivery, the uterus gradually shrinks back to its non-pregnant size. Typically takes about 6 weeks postpartum. Subinvolution This occurs when that process is slower than normal. Causes Retained placental fragments Infection (endometritis) Uterine atony (lack of muscle tone) Fibroids or other uterine abnormalities Signs and Symptoms Prolonged lochia (postpartum vaginal discharge), especially if it's heavy or foul-smelling Uterus larger and softer than expected on exam Pelvic pain or tenderness Possibly fever if infection is present Diagnosis Clinical exam (uterine size) Ultrasound (to detect retained products) Blood tests (if infection is suspected) Treatment Ergometrine or oxytocin to promote uterine contractions Antibiotics if infection is present Surgical removal of retained products if necessary. #diagrame