Lochia: Normal bleeding and discharge after birth

                                                LOCHIA

It is the vaginal discharge for the first fortnight during puerperium. The discharge
originates from the uterine body, cervix and vagina.

Odour and reaction -
It has got a particular offensive fishy smell. Its reaction is alkaline tending to becomes
acid toward the end.

Composition -
Depending upon the variation of the colour of the discharge, it is named as

Name	Colour	Duration	Composition
Lochia rubra	Red	1-4 days	Blood, shreds of fetal membranes and deciduas, vernix caseosa, lanugo and meconium
Lochia serosa	Yellowish or pink	5-9 days	Leucocytes, wound exudates, mucous from the cervix and micro-organisms
Lochia alba	Pale white	10-15 days	Decidual cells, leucocytes, mucous, cholestrin crystals, fatty and granular epithelial cells and micro-organisms

Amount -
The average amount of discharge for the first 5-6 days, is estimated to be 250 ml.

Normal duration -
It may extend up to 3 weeks.

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.

• Odour :- If offensive, indicates infection.
• Amount :- Scanty or absent - signifies infection. If excessive - indicates infection.
• Colour :- Persistence of red colour beyond the normal limit signifies subinvolution                      or retained bits of conceptus.
• Duration :- Duration of the lochia alba beyond 3 weeks suggests genital lesion.