What might indicate retained tissue in the uterus after delivery?

Retained tissue in the uterus after delivery can lead to complications such as hemorrhage and infection. One of the key indicators of retained tissue is a higher than expected fundus position. Normally, after the delivery of the placenta, the fundus, which is the top part of the uterus, should be firm and located at a predictable height based on the number of days postpartum. If the fundus is higher than expected, this can signal that there is tissue remaining in the uterus, which prevents it from involuting properly.

In contrast to this indication, a firm and midline fundus typically suggests that the uterus is contracting adequately and is likely empty of retained tissue. Immediate post-delivery contraction is a normal finding, showing that the uterus is expelling the placenta and returning to its non-pregnant state. Stable vital signs indicate that there is no acute distress or significant hemorrhaging occurring, which would be expected if retained tissue were present. Thus, recognizing that a higher position of the fundus can indicate potential complications is crucial in postpartum care.