Lochia
In the field ofobstetrics,lochiais thevaginal dischargeafter giving birth, containingblood,mucus,anduterinetissue.[1]Lochia discharge typically continues for four to eight weeks afterchildbirth,[2]a time known as thepostpartum periodor puerperium. A 2016 review ties this "lochial period" to worldwide customs ofpostpartum confinement,a time for the new mother and baby to bond.[3]
Lochia is sterile for the first two days, but not so by the third or fourth day, as the uterus begins to be colonized by vaginal commensals such as non-hemolyticstreptococciandE. coli.[4]
Stages[edit]
It progresses through three stages:[5]
- Lochia rubra(or cruenta) is the first discharge, composed of blood, shreds of fetal membranes,decidua,vernix caseosa,lanugoand membranes. It is red in color because of the large amount of blood it contains. It lasts 1 to 4 days after birth, before easing to light "spotting".[6]
- Lochia serosais the term for lochia that has thinned and turned brownish or pink in color. It contains serousexudate,erythrocytes,leukocytes,cervicalmucusand microorganisms. This stage continues until around the tenth day after delivery. Lochia serosa which persists to some weeks after birth can indicate late postpartum hemorrhaging, and should be reported to a physician.
- Lochia alba(or purulenta) is the name for lochia once it has turned whitish or yellowish-white. It typically lasts from the second through the third to sixth weeks after delivery. It contains fewerred blood cellsand is mainly made up ofleukocytes,epithelial cells,cholesterol,fat,mucusandmicroorganisms.Continuation beyond a few weeks can indicate a genital lesion, which should be reported to a physician.
Complications[edit]
In general, lochia has an odor similar to that of normal menstrual fluid. Any offensive odor or change to a greenish color indicates contamination by organisms such as chlamydia orstaph saprophyticus.[7]
Lochia that is retained within the uterus is known aslochiostasis[8]or lochioschesis, and can result inlochiometra[9](distention of the uterus - pushing it out of shape).Lochiorrheadescribes an excessive flow of lochia and can indicate infection.[10]
References[edit]
- ^Murkoff, Heidi;Eisenberg, Arlene; Hathaway, Sandee (2002).What To Expect When You're Expecting(3rd ed.). New York: Workman. p.383.ISBN0-7611-2132-3.
This discharge of leftover blood, muscus, and tissue from your uterus, known as lochia, is normally as heavy as (and sometimes even heavier than) a menstrual period for the first three to ten postpartum days.
- ^Oppenheimer, LW; Sherriff, EA; Goodman, JD; Shah, D; James, CE (July 1986). "The duration of lochia".Br J Obstet Gynaecol.93(7): 754–757.doi:10.1111/j.1471-0528.1986.tb08063.x.PMID3755355.S2CID221487083.
- ^Sharma S, van Teijlingen E, Hundley V, Angell C, Simkhada P. Dirty and 40 days in the wilderness: Eliciting childbirth and postnatal cultural practices and beliefs in Nepal.BMC Pregnancy Childbirth.2016;16(1):147. Published July 5 2016.doi:10.1186/s12884-016-0938-4
- ^Hanretty, Kevin P. (2009).Obstetrics Illustrated.Illustrated by Ian Ramsden and Robin Callander (7th ed.). Churchill-Livingston. p. 337.ISBN978-0-7020-3066-6.Retrieved13 November2013.
- ^Sherman, D.; Lurie, S.; Frenkel, E.; Kurzweil, Y.; Bukovsky, I.; Arieli, S. (1999). "Characteristics of normal lochia".Am J Perinatol.16(8): 399–402.doi:10.1055/s-1999-6818.PMID10772198.
- ^"Postpartum Bleeding: What To Expect and How To Manage It".Yoppie.
- ^"What Is Lochia".Elite Doula.
- ^"lochioschesis - definition of lochioschesis in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia".
- ^"lochiometra - definition of lochiometra at the Free Dictionary by Farlex".
- ^Shevtsova, Maria."Postpartum Bleeding – The Healing Wound".Mother How.
Also, a profuse lochia discharge three weeks after childbirth can be a sing of lochiorrhea. Lochiorrhea may indicate an infectious disease in a woman or a sign of disturbed blood coagulation.