A woman is seen six weeks after an uncomplicated vaginal delivery. Her uterus is still palpable above the symphysis pubis, larger than expected, and softer than normal. Which finding would be the MOST likely underlying cause?

• A Bladder distension masking the true size
• B Lactation suppressing oxytocin release
• C Normal variant of involution in a multipara
• D Retained products of conception with endometritis ✓

Explanation

Subinvolution is diagnosed when the uterus fails to return to its nonpregnant size, remaining palpable abdominally beyond two weeks. The two classic causes are retained products of conception and endometritis, both of which interfere with normal contraction and thrombosis of vessels at the placental site. Lactation promotes rather than suppresses involution through oxytocin release, so option B states the opposite of the physiology.

Reference: DC Dutta's Textbook of Obstetrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.