What does a firm uterine fundus, 2 cm above the umbilicus and displaced to the right, suggest?

A firm uterine fundus located 2 cm above the umbilicus and displaced to the right indicates the presence of bladder distention. When the bladder becomes distended, it can push the uterus from its central position to the side, leading to a lateral displacement. This condition is commonly observed in postpartum patients, especially in the first few hours after delivery.

Uterine contraction is an essential factor for maintaining uterine tone and preventing complications such as hemorrhage. In the scenario presented, since the uterus is firm and not exhibiting signs of atony (which would present as a boggy or soft fundus), it suggests that uterine atony is not the issue. Similarly, a firm fundus does not point towards infection, and while postpartum hemorrhage could cause some displacement, it typically would present with a soft or distended fundus. Therefore, the specific characteristics of the firm fundus, along with the displacement, primarily indicate that bladder distention is the underlying cause in this scenario.