Lochia and Bleeding in Postpartum Care

Questions and Answers

Name the 3 types of Lochia.

Rudra, Serosa, Alba

Lochia is made up of?

Vaginal blood, tissue and mucous

When does Lochia Rubra occur, what does it consist of, and how long does it last?

After birth, erythrocytes, decidua, bacteria, lasts 2-4 days postpartum.

When does Lochia Serosa occur, what does it consist of, and how long does it last?

Days 3-4, old blood, serum, leukocytes, tissue, lasts 3-21 days postpartum. Signup and view all the answers

When does Lochia Alba occur, what does it consist of, and how long does it last?

After Serosa, leukocytes, decidua, epithelial cells mucous/bacteria, lasts 4-8 weeks. Signup and view all the answers

Bleeding that occurs around day 10 postpartum is caused by a release of ____________ from the uterus.

Eschar bleeding Signup and view all the answers

What size blood clot is considered normal postpartum?

No bigger than an egg or golf ball Signup and view all the answers

How much bleeding is considered abnormal postpartum?

Soaking more than one maxi pad in 1 hour, passing clots the size of an orange. Signup and view all the answers

What drugs are used to stop abnormal bleeding?

Pitocin, Methergine, Misoprostol Signup and view all the answers

Hemorrhage occurring after 24 hours and until 12 weeks postpartum is considered?

Delayed, late or secondary postpartum hemorrhage. Signup and view all the answers

After a normal spontaneous vaginal delivery (NSVD), how much blood loss is considered normal?

500ml Signup and view all the answers

If the uterus is boggy and off center, and the pulse is elevated with a dropping blood pressure, what could this indicate?

Postpartum hemorrhage Signup and view all the answers

Study Notes

Lochia Types

Lochia consists of three types: Rubra, Serosa, and Alba.
Lochia Rubra occurs immediately after birth and lasts for 2-4 days, made up of erythrocytes, decidua, and bacteria.
Lochia Serosa begins around day 3-4 postpartum and lasts for 3-21 days, containing old blood, serum, leukocytes, and tissue.
Lochia Alba follows Lochia Serosa and can last from 4 to 8 weeks, composed of leukocytes, decidua, epithelial cells, mucous, and bacteria.

Composition of Lochia

Lochia is a combination of vaginal blood, tissue, and mucous expelled post-delivery.

Eschar Bleeding

Occurs around day 10 postpartum due to the release of scab from the placental attachment site.
This bleeding may last 1-2 hours before lochia normalizes in color and amount.

Normal and Abnormal Bleeding

Normal postpartum blood clots should be no larger than an egg or golf ball.
Abnormal bleeding is indicated by soaking more than one maxi pad in one hour or passing clots the size of an orange.

Medications for Abnormal Bleeding

Pitocin, Methergine, and Misoprostol are used to manage and stop abnormal bleeding.

Postpartum Hemorrhage

Delayed or secondary postpartum hemorrhage occurs between 24 hours and 12 weeks postpartum, often caused by uterine atony, retained placental fragments, or sub involution of the uterus.
A boggy, off-center uterus with elevated pulse and dropping blood pressure may indicate postpartum hemorrhage.

Blood Loss Considerations

Normal blood loss after a normal spontaneous vaginal delivery (NSVD) is considered to be 500ml.

Description

Explore important concepts related to lochia, including its types and composition in the postpartum period. This quiz covers the normal versus abnormal bleeding and provides key definitions to understand the changes that occur after childbirth.