Lochia
Lochia-
It is the vaginal discharge for the first fortnight during puerperium. The discharge originates from the uterine body, cervix and vagina.
For the first 2 hours after birth the amount of lochia should be about that of a heavy menstrual period.
Odor and reaction-
It has got a peculiar offensive fishy smell. Its reaction is alkaline, tending to become acid toward the end.
Color-
Depending upon the variation of the color of the discharge, it is named as
- Lochia rubra (red) 1–4 days
- Lochia serosa (5–9 days) - The color is yellowish or pink or pale brownish
- Lochia alba- (pale white) -10–15 days.
Composition-
Lochia rubra -consists of blood, shreds of fetal membranes and decidua, vernix caseosa, lanugo and meconium.
Lochia serosa- consists of less RBC but more leukocytes, wound exudate, mucus from the cervix and microorganisms (anaerobic streptococci and staphylococci). The presence of bacteria is not pathognomonic unless associated with clinical signs of sepsis.
Lochia alba- contains plenty of decidual cells, leukocytes, mucus, cholesterin crystals, fatty and granular epithelial cells and microorganisms. Amount: The average amount of discharge for the first 5–6 days is estimated to be 250 mL.
| Lochial bleeding | Nonlochial bleeding |
| Lochia usually trickles from the vaginal opening, the steady flow is greater as the uterus contracts. | Body discharge spurts from the vagina. |
| A gush of lochia may result as the uterus is massaged. | The amount of bleeding continues to be excessive and bright red |
Normal duration-
The normal duration may extend up to 3 weeks. The red lochia may persist for longer duration especially in women who get up from the bed for the first time in later period. The discharge may be scanty, especially following premature labors or may be excessive in twin delivery or hydramnios.
Clinical importance-
The character of the lochial discharge gives useful information about the abnormal puerperal state. The vulval pads are to be inspected daily to get information of-
Odor-
If malodorous indicates infection. Retained plug or cotton piece inside the vagina should be kept in mind.
Amount-
Scanty or absent signifies infection or lochiometra. If excessive — indicates infection.
Color-
Persistence of red color beyond the normal limit signifies subinvolution or retained bits of conceptus.
Duration-
Duration of the lochia alba beyond 3 weeks suggests local genital lesion