Involution of the uterus after childbirth. Age and postpartum involution of the body of the uterus

The process of involution (reverse development) of the uterus occurs quickly. As a result of the contractile activity of the muscles, the size of the uterus decreases. The degree of contraction of the uterus can be judged by the level of standing of its bottom. During the first 10-12 days after childbirth, the bottom of the uterus drops by about 1 cm daily. overflow Bladder- above the navel.

Measurement with a centimeter tape shows that on the 2nd day the bottom of the uterus is located 12-15 cm above the pubic junction, on the 4th day - 9-11 cm, on the 6th day - 9-10 cm, on the 8th - by 7 - 8 cm, on the 10th - by 5 - 6 cm or at the level of the pubis. By the end of the 6th - 8th week after birth, the size of the uterus corresponds to the size of the non-pregnant uterus (in lactating women it may even be smaller).

By the end of the first week, the mass of the uterus decreases by more than half (350-400 g), and by the end of the postpartum period it is 50-60 g. The internal os and cervical canal are also quickly formed. If immediately after childbirth, the internal os was passable for the hand, then after 24 hours it passes two fingers, and after 3 days it is barely passable for one finger.

The formation of the pharynx occurs due to the contraction of the circular muscles surrounding the internal opening of the cervical canal. By the 10th day after birth, the canal is fully formed, but the external pharynx is passed even for the tip of the finger. The closure of the external os is completed completely on the 3rd week after birth, and it acquires a slit-like shape.

Thus, the formation of the cervix and its canal occurs from top to bottom. As a result of the contraction of the uterus and the circular muscles located around the internal os, the border between the upper and lower segments of the uterus is indicated.

Its bottom in the first days of the postpartum period is in contact with the inner surface abdominal wall, between the body and the cervix an angle is formed, open anteriorly (anteflexio uteri). In the following days, the bottom of the uterus often deviates backwards, which is facilitated by the relaxation of the ligamentous apparatus and the lying of the puerperal on her back.

"Obstetrics", V.I.Bodyazhyna

Subinvolution of the uterus

Subinvolution of the uterus - a delay in the process of reverse development of the uterus after childbirth, caused by viral or mechanical damage. Wherein pathological condition the uterus cannot contract to its natural prenatal size. This phenomenon refers to postpartum complications.

Causes

Causes of subinvolution of the uterus include:

Retention of parts of the placenta or membranes in the uterine cavity
Multiple pregnancy or large fruit
Polyhydramnios
Rapid or prolonged labor
Childbirth through caesarean section
uterine fibroids
Presence in a woman during pregnancy inflammatory processes accompanied by pyelonephritis and anemia
Infection during childbirth

Symptoms of subinvolution of the uterus

The first symptom of subinvolution of the uterus is incessant brown bleeding. On examination, the gynecologist notes that the uterus is enlarged, has an insufficiently dense consistency, and the rate of its contraction is slowed down. Sometimes there is a slight increase in body temperature (37-37.5o) for a long time. This indicates the presence of a sluggish inflammatory process in the body.

Another symptom is the absence of the usual postpartum cramping pains in the lower abdomen, including during breastfeeding.

Diagnostics

The diagnosis of subinvolution of the uterus is made on the basis of clinical symptoms this complication, according to the characteristic state of the uterus compared with the norm for a given postpartum day. Examination methods include examination using mirrors, bimanual examination, and ultrasound scanning. Ultrasound provides an objective assessment of the size of the uterus, which allows timely diagnosis of subinvolution.

Sonography is used to determine the presence of pathological inclusions in the uterine cavity. This is necessary for the choice of treatment tactics.

Types of disease

Depending on the cause of occurrence, the following types of subinvolution of the uterus are distinguished - infectious and true.

Subinvolution of an infectious nature is caused by inflammatory processes after childbirth against the background of pyelonephritis and anemia of pregnant women. The infection can be introduced during childbirth. Also, inflammation occurs when the remnants of the placenta and fetal membranes are retained in the uterine cavity.

True subinvolution is caused by mechanical overstretching of the uterus, or cervical fibroids, adenomyosis.

Patient's actions

If persistent heavy brown bleeding occurs after childbirth, the woman must report this symptom to the obstetrician.

If symptoms occur after discharge from the hospital, you should not postpone going to the gynecologist.

Treatment of subinvolution of the uterus

Treatment of subinvolution of the uterus depends on the type and clinical course. If subinvolution is accompanied by an inflammatory process, then it is an independent disease, for the treatment of which antibiotics are used. If an infection is detected, in addition to antibiotics, drugs are prescribed that thin the blood and improve blood circulation in the uterus. The treatment period is usually 7-10 days.

For the treatment of true subinvolution, drugs that stimulate muscle tone are prescribed. In the absence of intoxication, blood clots are removed from the uterine cavity with a vacuum pump. Cold water is used to flush out lochia from the vagina. brine. As a local treatment, rectal massage of the uterus and ovaries can be prescribed.

In the presence of a virus, the use of the method of intramuscular injection of ergot, oxytocin, sinestrol, or colostrum preparations is likely. Effective therapy is novocaine and autohemotherapy.

Neofur, metromax, hysteroton, exuter or furazolidone sticks are administered intrauterinely, a glucose solution with ascorbic acid is administered intravenously.

Complications

As a result of subinvolution of the uterus, postoperative endometritis, stagnation of lochia and the development of infection may occur.

Prevention of subinvolution of the uterus

Prevention of subinvolution of the uterus is carried out at the stage of pregnancy planning. It consists in performing a set of Kegel exercises, which contribute to a good contraction of the uterus and allow you to restore its normal size from a stretched state.

Translated from Latin, Involutio means curtailment, regressive changes. They occur in the female body in two periods - postpartum and menopause. Involution is not a disease or a pathology. This concept denotes the physiological process of reverse development in cellular elements, tissues and organs.

Postpartum involution

In the female body, reverse changes are considered normal and natural, predetermined by nature. All phases of this process proceed according to their schedule.

With the birth of a child, the reproductive system of a woman is rebuilt again. Pregnancy hormones are not produced, until their prenatal state, the reproductive tract gradually begins to recover. It is believed that this period normally passes in three months.

Uterus

It takes about two months for the uterus to fully recover to its original size.

In the first days after childbirth, the walls of the organ are thickened, from peripheral contractions it has decreased in size, but still has a spherical, flattened shape, and it can be determined by palpation, about 12–14 cm above the pubic symphysis. After all, its weight is still about 1 kg with an approximate 500 ml. The non-pregnant uterus weighs only 70 g and holds 5 ml. The lysis (dissolution) of proteins contributes to its return to prenatal size, and the number of muscle cells remains the same, and they simply decrease in size. blood walls and lymphatic vessels are compressed, and some of them completely obliterate (close). Additional nerve, muscle and connective tissue cells undergo protein and fat degeneration and disintegrate. How does the involution of the uterus affect the weight of the organ:

End of the first week: minus 550–600 BC
Second week: minus 300 g.
Third week: minus 150–200 years

By the seventh or tenth day, small lesions on the neck, vagina, and perineum are epithelialized. By the end of the second week, the organ is already located only in the small pelvis, and by the sixth it returns to its regular sizes, acquiring a cylindrical shape. The neck isthmus is already closed.

Lochia

Postpartum discharge suggests that the healing of the inner walls of the uterus is normal. Lochia (wound secretion) consists of the remaining particles of the membranes, blood clots have a neutral or slightly alkaline reaction with a specific odor. If in the first 2-3 days they are abundantly bloody, then over time they become bloody-serous in nature due to a large number in their composition of leukocytes. By the end of the first week, they become more serous and transparent-watery, and by the sixth they completely stop. Involution of the uterus is completed. From the eighth week, a woman is already allowed to have sex.

Subinvolution

Under the influence of a number of adverse factors, reverse changes do not occur or are delayed. The opposite process, in which the uterus is not able to contract to its natural size, subinvolution, is diagnosed by the end of the first week after delivery. There are two types of this pathology:

Subinvolution of an infectious nature. The reason is inflammatory processes against the background of chronic diseases (pyelonephritis, anemia) or as a result of an infection that has developed due to particles of the placenta or fetal membrane remaining in the uterine cavity.
True subinvolution comes from excessive mechanical overstretching of the organ walls.

It can be caused by a number of adverse factors:

Severe pregnancy.
Multiple pregnancy.
Polyhydramnios.
Large fruit.
Anomalies of labor activity.
Caesarean section.
Depressed immune system.

Bacterial or viral infections, mechanical damage to the internal genital organs can slow down the reverse transformation process. The rate of uterine involution after childbirth can also be affected by age (over 30 years), general state organisms associated chronic diseases. The main warning signs of subinvolution are:

Abundant brown discharge mixed with blood, the appearance of an unpleasant odor
Temperature rise.
Palpitations, weakness.
There is no cramping pain in the lower abdomen during feeding.

If a woman is discharged from a maternity hospital, she should see a doctor as soon as possible with these symptoms.

After examination and ultrasound examination, the specialist determines the type of pathology and prescribes therapy:

When the inflammatory process became the cause, antibiotics and drugs that improve uterine circulation are indicated. If necessary, carried out vacuum aspiration blood clots from the body cavity.
With true subinvolution, special drugs are prescribed that stimulate muscle tone uterus.

Usually the course of treatment lasts from 10 to 14 days. If a woman applied for medical care, the prognosis for recovery is favorable.

In most cases, the woman provokes subinvolution herself. To avoid it after childbirth and cesarean section, you need to walk as much as possible, roll over on your stomach and pay attention to breastfeeding. With good and established lactation, the chance of subinvolution occurring is negligible.

Climacteric involution

Against the background of age-related hormone deficiency, the uterus, as the most vulnerable and sensitive organ, is the first to change. In the period of premenopause, it first increases in size, but loses its density. Myometrium begins to regenerate, being replaced by connective tissue. So gradually the uterus loses its contractility. Atrophic processes in the myometrium reduce the organ in volume by about half. The cervix becomes short, the lumen of the cervical canal is tightened or completely overgrown.

With the extinction of the myometrium, the function of the mucous glands decreases and the amount of vaginal mucus begins to decrease. A jump in such changes is observed in women in the first two years of postmenopause. By this time, the involution of the uterus stops, and 12–15 years after menopause, the organ shrinks to the size of the tonsil. The female genital area atrophies and completely fades away.

After the birth of a child, recovery processes take place in the female body. All organs reproductive system are undergoing changes. The uterus after childbirth is very much injured.

The uterus is like an inverted pear. It is a hollow organ made up of smooth muscles. It stretches due to the interweaving of muscle fibers and the action of hormones during pregnancy.

The hollow organ consists of the body, which in the prenatal state is about 5 cm, and the cervix is 2.5 cm in size. At the birth of a child, the tissues stretch and grow with the fetus.

Recovery (involution) female organs after childbirth is a natural process. If the delivery was natural, then the uterus is restored and reduced within 2 months.

The postpartum period is:

early - 2 hours after the birth of the placenta;
late - up to 8 weeks after delivery.

Scars on the uterus after childbirth are normal. Severe damage is located in the placenta attachment zone. In this zone, there are most of the vessels that are thrombosed.

Blood clots in the uterus after childbirth and the remains of the placenta will leave the body within three days. These selections are called.

Epithelialization (restoration of endometrial tissues) occurs by 10-12 days after birth. And the scar at the site of attachment of the placenta heals by the end of the first month.

The uterus after childbirth is a sterile organ. For 3–4 days, processes such as phagocytosis and proteolysis take place in the hollow organ. During them, the bacteria in the uterine cavity are dissolved with the help of phagocytes and proteolytic enzymes.

The first days after the birth of a child, the hollow organ is too mobile due to sprains and insufficient tone of the ligamentous apparatus. This is noticeable with a full bladder or rectum. The tone is acquired in a month.

How long does the uterus shrink after childbirth?

The contractions of the uterine cavity feel like contractions. On the first day after delivery, they do not have a aching character.

The release of the hormone oxytocin during breastfeeding causes muscle spasms. During the contraction of muscle tissue, blood and lymph vessels are compressed, and some dry up - obliterate.

Tissue cells that appeared during pregnancy die and dissolve, while the rest decrease in volume. This contributes to the recovery of the uterus after childbirth.

Change in organ mass:

after childbirth - 1 kg;
after 7 days - 500 - 525 grams;
after 14 days - 325 - 330 grams;
at the end of the postpartum period - 50 - 65 grams.

To speed up contractions, immediately in the delivery room, after the birth of the placenta, ice or a cold heating pad is placed on the stomach.

Postpartum parameters of the uterus:

the organ is 15–20 cm long;
its transverse size is 12–13 cm;

The bottom of the hollow organ after the process of childbirth drops sharply, not reaching the navel by 2.5 cm, and the body tightly touches the abdominal wall. The uterus has a dense structure and often shifts to the right.

Due to contractions, it drops by 1 cm daily. At the end of the first week, the bottom reaches the distance between the navel and the pubic area. Already on the 10th day, the uterus is below the pubis.

The neck recovers more slowly: 12 hours after birth, its diameter will be 5–6 cm. By the middle of the second week, the internal pharynx closes, and the outer one forms at the end of the second month after birth.

The pharynx is not restored to its original form, since the tissue fibers are too stretched. On this basis, the gynecologist can determine whether a woman gave birth or not.

Initially, the pharynx has a round hole. After childbirth, a transverse gap remains on it. The shape of the cervix changes: if earlier it had the form of a cone, now it is a cylinder. Gradually, all organs return to normal.

Recovery after caesarean section

Since operative delivery involves a violation of the integrity of the uterus, it is restored more slowly. Infections and complications can slow the contraction. Recovery of the uterus after childbirth can be slow due to large blood loss.

Atony and hypotension

The hollow organ needs to be restored after childbirth, the uterus cannot always contract on its own. Some women have this situation.

In these cases, medical intervention is indispensable. This condition is called uterine atony. If the contractions are very weak - hypotension.

Common causes for atony:

second birth;
first pregnancy;
multiple pregnancy; More about multiple pregnancies→
large weight and size of the child;
various complications;
trauma to channels or appendages.

The bend of the uterus after childbirth or the pathology of its development can contribute to the absence of contractions.

How to accelerate uterine contraction after childbirth?

Recovery speed depends on the following factors:

hormonal background;
woman's age;
child parameters;
number of past pregnancies;
type of labor activity;
polyhydramnios;
inflammation of the genitals.

Nature has thought out the female body to the smallest detail. Restoration of a hollow organ occurs according to the standard dimensions of 1-2 cm daily. But if minor deviations from the norm begin to be noticed, you can resort to accelerating the reduction process.

Recovery of the uterus after childbirth involves the following actions:

If the uterine fundus is soft, then the uterus will contract more slowly. An effective method is to massage the surface of the abdominal wall from the outside.
To reduce the organ after childbirth, a cold heating pad or ice is applied to the stomach. Spasm-stimulating drugs may be used.
Observe the hygiene of the genitals. The penetration of infections and various complications affect the ability to contract.
Active walks.
Do not allow the bladder and rectum to fill.
Lactation. At breastfeeding oxytocin is released, causing uterine contractions. Nursing mothers restore the uterus faster.
Postpartum gymnastics, stimulating the contraction of the muscles of the uterus.

Restoration of the uterus should take place under the strict supervision of a physician. Any deviation from the norm is a pathology and requires surgical intervention.

postpartum discharge

Blood in the uterus after childbirth is formed due to wounds on the surface. The secretions are called lochia. The secret of 3-4 days is red. At this time, lochia have a sweet smell of blood.

For 20% they consist of the fluid of the uterine glands, and the rest is unchanged blood. Restoration of the mucous tissues of the uterus begins immediately after delivery.

If the discharge lasts longer than the specified period or has an unpleasant odor, be sure to consult a doctor.

This may happen for the following reasons:

bending of the cervix;
weak contractions in the uterus;
blockage of the pharynx with blood clots.

This condition is dangerous, as it may indicate an inflammatory process. If the lochia ended in the fifth week or go longer than the ninth, you need to contact a gynecologist.

Process flow without deviations:

Vessels burst in the cavity, as a result of which bloody issues 2-3 days have a bright red color.
During the first 7 days, the remnants of the placenta and atrophied endometrium come out - discharge with clots.
After 7 days, liquid lochia has a pinkish tint.
Mucus gradually comes out - the result of the activity of the fetus inside the womb. They stop within a week.
After a month and a half, lochia disappears, spotting appears.

What complications may arise

After the birth process, various complications can occur.

postpartum hemorrhage

It can begin immediately after delivery. Bleeding is not accompanied by pain, and is very strong. A woman's life without surgery can be in jeopardy.

Causes of bleeding:

violations occurred during the separation of the placenta and membranes;
trauma during childbirth;
impaired uterine contraction.

Medicines and donated blood are used for treatment. Because of the risks of bleeding, the woman is always left in the delivery room for several hours.

Subinvolution of the uterus

As a result of the delay in postpartum secretions, the organ is poorly reduced. Often this disease appears on the 6-7th day: clots in the uterus after childbirth or part of the fetal membrane block the cervical canal.

endometritis

Inflammation of the uterus is called endometritis. It appears due to infection of the cavity.

ATThe occurrence may be due to the following factors:

severe birth process;
the placenta did not separate properly during childbirth;
diseases of the genital organs during pregnancy;
decrease in immunity.

Symptoms of endometritis:

heat;
after childbirth, the uterus hurts;
rotten smell of postpartum discharge.

To make an accurate diagnosis, an ultrasound of the uterus is performed after childbirth. With endometritis, the cavity is removed, washed or scraped from the contents. After surgery, antibiotics are prescribed.

Prolapse

It may happen that after childbirth the uterus sank. This occurs as a result of injury to the muscle tissue of the pelvic floor. This complication often affects women who are carrying a second child.

Normally, the uterus after childbirth at the exit of the placenta is located in the navel. The bottom sinks 1–2 cm daily.

Any deviation from the norm is considered a pathology. At severe forms there may be a prolapse of the uterus after childbirth into the vagina and go outside.

It is necessary to treat prolapse in a timely manner so as not to be at risk of infection, prolapse internal organs urinary system. When the uterus prolapses sex life prohibited.

To reveal possible pathologies at 6–9 weeks after childbirth, it is recommended to visit a gynecologist. Even if you feel good, there are no pain and discomfort.

Recovery of the uterus after childbirth

All women are interested in how the uterus looks after childbirth. Its cavity decreases from 40 to 20 cm, and is restored daily by 1–2 cm. In order for the contractions to be normal, it is necessary to periodically examine the gynecologist. There are many methods for restoring the uterus.

Traditional medicine

Nettle has a good effect on uterine contraction. Three tablespoons of the plant insist in 0.5 liters. boiling water. Let stand and cool. Drink 1/2 cup 3 times a day.

In the pharmacy you can buy a tincture of water pepper. It also promotes uterine contractions.

The flowers and grass of the white lamb are used in the decoction and help to restore the hollow organ. The decoction does not cause an increase in pressure. It can be drunk with hypertension.

With bleeding, the shepherd's purse plant helps well. In a day, you can use tea leaves 3-4 tbsp. tablespoons of herbs per 400 ml of boiling water.

Also, with abundant bloody lochia, red geranium helps. Drink cold tea from 2 teaspoons of a dry plant in 2 cups of boiling water. The liquid must stand overnight. Drink small portions throughout the day.

Postpartum cleansing helps to speed up May birch leaves. Three tablespoons of leaves are brewed in 600 ml of boiling water. Add a pinch of soda and drink 200 ml 3 times every day. The remedy is effective from 12 days after the birth process.

Physical recovery methods

Feeding a baby releases oxytocin, which affects uterine contractions.

From the first day you can do easy physical exercises- postpartum recovery exercises. Charging should be carried out in a well-ventilated area at an optimum temperature of 18 to 20 degrees.

If pain is felt, physical exercises should be stopped or another set of exercises should be chosen for oneself.

All complex measures aimed at restoring the female body must be carried out within 10-12 weeks. Before training, it is recommended to go to the toilet. deal with full bladder, gynecologists do not advise. Also, exercise should be done after breastfeeding.

If there were complications surgical intervention or childbirth after uterine rupture, physical exercises must be agreed with the gynecologist.

To avoid complications during childbirth, during pregnancy, you need to regularly visit a gynecologist. Recovery period every woman is different, but if there are deviations from the norm, you need to see a doctor.

Useful video on the topic: Why you need to tie up your stomach after childbirth and how to do it

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- postpartum complication, characterized by a slowdown in the recovery of normal (prenatal) size of the uterus. Symptoms are profuse brown bloody discharge, subfebrile temperature body, the absence of the usual cramping pains when breastfeeding. The presence of a complication is determined by means of a gynecological examination, ultrasound examinations (ultrasound of the uterus, three-dimensional echography). The treatment is complex, including hormonal drugs - myometrial contraction stimulants, antibiotics or antiviral agents. To stimulate involution, blood clots are removed from the uterus, and gynecological massage is performed.

ICD-10

N85.3

General information

The prefix "sub" in the term "subinvolution" means incomplete or partial involution (recovery) of the uterus after childbirth. It is a fairly common postpartum complication - it is recorded in 1-2% of women in labor, and among all pathologies after childbirth, its share is 30-50%. There is a scientific discussion as to whether this condition should be considered a separate nosological entity. Many experts attribute it to the first manifestations of postpartum endometritis - a group of infectious complications after childbirth. According to another point of view, subinvolution is an independent disease, caused by bacterial or viral infection and almost always leads to endometritis.

Causes of subinvolution of the uterus

Diagnostics

Obstetrician-gynecologists, already at the stage of pregnancy, determine a risk group among women who are more likely to develop subinvolution. It includes pregnant women with polyhydramnios, fibroids, large fetuses, infectious and inflammatory pathologies of the genitourinary system, pronounced signs of preeclampsia. Such women need special monitoring in the postpartum period for the timely detection of complications and the start of their treatment. To diagnose the condition, a range of obstetric studies and general clinical tests are used:

Obstetrician consultation. The specialist conducts an inquiry, during which he determines the nature, volume and duration of lochia, the presence or absence of subjective symptoms. Based on the data obtained, the doctor prescribes a number of additional diagnostic procedures.
Look at the chair. A bimanual examination reveals an increase in the uterus (not corresponding to the period after childbirth), a pear-shaped spherical shape of the organ. The elastic-soft consistency indicates the presence of the remains of the placenta in the birth canal. When viewed with mirrors, swelling and purpleness of the cervix are determined, the cervical canal is enlarged (1-2 fingers pass easily), blood clots are detected in its cavity.
Ultrasound research. To diagnose complications, transabdominal and transvaginal ultrasound of the pelvic organs, three-dimensional echography are used. The high standing of the bottom of the uterus is determined, which does not correspond to the postpartum period, the thickening of its walls. Ultrasound can accurately determine the presence of foreign bodies and residual placenta in the uterine cavity.
Hysteroscopy. Endoscopic examination of the internal cavity of the uterus often reveals signs of subinvolution and endometritis even before the peak clinical manifestations. In addition to examination, the technique makes it possible to take samples of the endometrium, lochia, and placenta residues for more accurate diagnosis.

In case of an infectious form of the disease or the addition of complications, diagnostic procedures are also prescribed clinical tests blood and urine, sometimes culture of the microflora of the vagina or uterus (with endometritis) is carried out to determine the pathogen. In the blood, changes characteristic of inflammatory processes are found - increase in ESR, leukocytosis, anemia. AT last years for diagnosis, a tomographic method is also used - MRI of the pelvic organs. It allows you to accurately determine the size and structure of the uterus and identify even the smallest pathological inclusions in its cavity.

Treatment of subinvolution of the uterus

Therapy of the condition is complex, including medication, instrumental and massage procedures. An important role in the effectiveness of therapeutic measures is played by determining the type of disease, and if it is infectious, the type of pathogen. The duration of treatment depends on the severity of the symptoms of the pathology and the presence or absence of concomitant diseases that may affect the organs of the woman's reproductive system. Effective Therapy subinvolution includes such drugs and treatments:

Hormonal agents. The contraction of the uterus after childbirth normally occurs under the influence of the hormone oxytocin. Therefore, to accelerate this process, hormonal drugs are used that affect the myometrium and its vessels - oxytocin, methylergometril and others.
Antibacterial therapy. The most common cause of infection in the postpartum period is the bacterial microflora. To eliminate it, broad-spectrum antibiotics are used. If, as part of the diagnosis, it was possible to determine the type of pathogen, antibiotic therapy is carried out with the most suitable drug in this case.
Removal of inclusions in the uterus. Remnants of the placenta and blood clots facilitate infection and can themselves cause inflammation. They are eliminated by vacuum aspiration or by curettage of the uterine cavity.
Gynecological massage. Able to improve the contractile properties of the myometrium and accelerate the recovery of the reproductive system after childbirth.
Public events. A woman with subinvolution of the uterus is shown bed rest, the absence physical activity and emotional stress. Regular attachment of the newborn to the breast also contributes to the contraction of the myometrium.

Forecast and prevention

Subinvolution of the uterus before the development of severe infectious complications responds well to therapeutic measures and is eliminated within a few weeks, therefore, it has a relatively favorable prognosis. The development of endometritis and other inflammatory conditions against this background is fraught with more serious consequences - the occurrence of sepsis, infection of other organs and systems ( abdominal cavity, urinary tract). Obstetricians recommend preventive actions women whose pregnancy and childbirth took place with complications (polyhydramnios, rapid delivery). They are in the appointment hormonal drugs to accelerate involution in the first days after the birth of a child, regardless of the presence of symptoms of a slowdown in uterine recovery.