Lochial discharge in postpartum period (puerperium)

The period after delivery is called as postpartum or postnatal period.

It can also be called puerperium. 

This extends upto 6 weeks postpartum. 

During this period, all organs in the body will start to come back to pre pregnancy state. 

Uterus will become abdominal organ in 2 weeks. 

And comes to pre pregnancy size in 6 weeks.  

During puerperal period, the woman will have lochial discharge. 

Usually this can be seen for first 4 to 5 weeks. 

There are three stages in lochial discharge. 

Lochia rubra : During first four days to one week of delivery.

It mainly contains blood. 

Excessive blood flow may indicate postpartum hemorrhage due to retained products of conception, placental bits, infection etc.

Lochia serosa : It will be thin brownish or pinkish discharge.

It mainly contains serous exudate, erythrocytes, leukocytes, cervical mucus etc.

This stage can last for 10 to 14 days after postpartum. 

If lochia rubra or serosa stages extend more than expected, that can be due to postpartum hemorrhage, retained products etc.

Lochia alba:Whitish or yellowish discharge. 

It contains epithelial cells, leukocytes, cholesterol, fat, mucus and few red blood cells etc.

This extends from 2nd week to 4 to 6 weeks after delivery. 

If this discharge extends more than expected or usual menstrual flow smell alters that can indicate infection, local lesions like cervical erosion etc. 

Lochiostasis or lochioschesis is retained lochia in uterus. 

This can occur due to cervical stenosis, intrauterine adhesions etc. 

This can lead to lochiometra, distention of uterus due to lochia.

Sometimes this can get infected.

Lochiorrhea is excessive lochial discharge. 

It can occur due to infection.

After delivery generally in non lactating women menstrual flow may return around 6 weeks after delivery.
Lactating women may have amenorrhea for around 6 months after delivery also.
This period may vary from person to person.



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