A 26-year-old woman presents on postpartum day 12 complaining of excessive red vaginal discharge. The uterus is palpable 3 cm above the symphysis pubis, larger than expected, and softer than normal. Temperature is 38 degrees C. What is the most likely underlying cause?
- A Uterine prolapse
- B Broad ligament haematoma
- C Retained products of conception ✓
- D Lochiometra from cervical occlusion
Correct answer: C. Retained products of conception
Explanation
Subinvolution is diagnosed when the uterus fails to descend at the expected 1 cm per day and remains large and soft. The most common causes are retention of placental fragments and endometritis, and this patient has both features with fever and prolonged red lochia. Broad ligament haematoma presents as a lateral pelvic mass with pain rather than delayed involution, while lochiometra gives amenorrhoea of lochia without fever.
Reference: DC Dutta's Textbook of Obstetrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.