Postpartum lower abdominal pain or vaginal swelling is a manifestation of uterine involution, the degree of uterine involution varies, the milder cases can only show postpartum lower abdominal pain or vaginal swelling, the more severe cases can cause painful shock. The diagnosis of postpartum lower abdominal cramps or vaginal cramps is based on: 1, medical history and labor management Previous history of uterine involution, combined with uterine dysplasia such as uterine malformation, twin pregnancies, excessive amniotic fluid, emergency delivery, standing birth, umbilical cord is too short or relatively too short, forceful squeezing of the uterine fundus or pulling the umbilical cord to assist delivery of the placenta, etc. The above clinical information can help diagnose uterine involution. 2. Pain manifestation The degree of pain varies. In mild cases, the pain can only be postpartum lower abdominal cramps or vaginal swelling, while in severe cases, it can cause painful shock. The typical pain of endometriosis is the sudden and severe lower abdominal pain after pulling the umbilical cord or pressing the bottom of the uterus during the third stage of labor, and it is important to note that this pain is continuous so as to distinguish it from the pain of uterine contraction. 3. Bleeding manifestations The bleeding characteristics exhibited after uterine involution vary. Patients with chronic endometriosis only show irregular vaginal bleeding or excessive menstruation; acute endometriosis bleeding is related to placental abruption, which may not bleed if the placenta is not aborted, but may show heavy bleeding if the placenta is partially aborted and completely aborted. 4, infection manifestation Infection is common in chronic endometriosis or acute endometriosis after reset by various methods, which can be manifested as both local infection of the reproductive system and pelvic and abdominal peritonitis or even septic sepsis. 5, shock The causes and mechanisms of shock are different because of the different clinical manifestations of endometriosis. In acute endometriosis with severe pain, painful shock can appear rapidly after endometriosis, which occurs relatively early, and vaginal bleeding does not match the degree of shock; acute endometriosis combined with postpartum hemorrhage can be complicated by hemorrhagic shock if bleeding is not controlled, anemia is corrected and microcirculation is improved in time; at the same time, pain and blood loss can interact with each other, leading to aggravation of shock. Chronic endometriosis can be complicated by infectious shock due to chronic blood loss and exudation, as well as the combination of various serious infections. 6. Local pressure manifestation In addition to the feeling of lower abdominal cramping, patients can have difficulty in defecation and urination.