A woman is reviewed six days after a normal vaginal delivery. Her uterus is palpable just below the umbilicus and she is concerned it is too large. By the end of which period should the normally involuting uterus have become a pelvic organ, no longer palpable abdominally?
- A End of the first week
- B End of the fourth week
- C End of the second week ✓
- D End of the sixth week
Correct answer: C. End of the second week
Explanation
Immediately after delivery the fundus lies about 12 cm above the symphysis pubis. It loses roughly 1 cm in height per day, and by the end of two weeks the uterus has shrunk enough to become a pelvic organ, no longer palpable through the abdominal wall. Complete anatomical restoration to the nonpregnant size takes about six weeks, but the pelvic organ milestone is two weeks. A fundus still palpable abdominally beyond two weeks suggests subinvolution, classically due to retained products or infection.
Reference: DC Dutta's Textbook of Obstetrics, 10th ed.
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