Introduction: After the fetus is delivered, the secretions flowing out of the mother’s vagina contain blood, necrotic decidua tissue, cervical mucus, etc., which is called lochia. Lochia discharge by mothers is a physiological phenomenon. How long does it take for it to drain normally?
Normal lochia has a bloody smell but is not smelly. There are three types of lochia. One is bloody lochia. This is the secretion discharged within the first to fourth days after delivery. It is large in amount and bright red in color. It contains blood, decidual tissue and mucus. It is similar to menstruation, or slightly more than menstrual flow, and sometimes contains blood clots. The second is serous lochia. This is discharged 4 to 6 days after delivery. It is light red in color and contains a small amount of blood, mucus and more vaginal secretions, as well as bacteria. The third is white lochia. This is white or yellowish lochia discharged one week after delivery. It contains a large number of white blood cells, decidual cells and bacteria. It looks like leucorrhea, but is more abundant than usual leucorrhea. Although every mother has lochia, the amount excreted varies from person to person. The average total amount is about 500 to 1000 ml. The length of time each mother continues to shed lochia is also different. A normal mother will be clear of lochia for about 3 weeks. If the lochia is still flowing more than two months after delivery, it is considered to be unclean lochia.
Three reasons for postpartum lochia
Tissue residue
It can be due to uterine malformation, uterine fibroids, etc., or it can also be due to the skill of the surgical operator. Unskilled surgery resulted in incomplete removal of pregnancy tissue, resulting in some tissue remaining in the uterine cavity. At this time, in addition to the unclean lochia, there was also bleeding, blood clots, and bouts of abdominal pain.
Uterine cavity infection
Uterine cavity infection can occur due to postpartum bathing, unclean sanitary napkins, sexual intercourse before the full month after delivery, or due to improper disinfection by the surgical operator. Infect. At this time, the lochia smells bad, there is tenderness in the abdomen, and is accompanied by fever. A blood test shows an increase in the total number of white blood cells.
Uterine atony
Uterine contractions and lochia may be caused by failure to rest well after childbirth, being weak and sick, or giving birth for a long time, which consumes energy and blood. Continuously.
Since the symptoms vary and the treatments are also different, by observing the nature, smell, amount and duration of lochia, we can understand the recovery of the uterus and the presence of infection. If the bloody lochia lasts for more than 2 weeks and is large in amount, it often indicates poor recovery of the placental attachment or residual placental membranes. If the lochia is not clean one month after delivery, accompanied by a foul or rancid smell, or abdominal pain , fever, it may be infection of the vagina, uterus, fallopian tubes, and ovaries; if accompanied by massive bleeding and the uterus is large and soft, it often indicates poor uterine involution. Therefore, you should go to the hospital in time and ask a doctor to find out the cause of lochia and treat it accordingly.
Diagnosis of unclean lochia
1. Three weeks after delivery, red lochia is still discharged from the vagina.
2. If the lochia has a foul odor, or is accompanied by low-grade fever, lower abdominal pain, poor uterine involution, or uterine tenderness, there is a uterine cavity infection.
3. When B-ultrasound examination shows poor uterine involution and there is tissue in the uterine cavity, it is the placenta or placental residue.
Immediate treatment
If you find that vaginal bleeding is heavy or prolonged, or the blood has a peculiar smell, you should go to the hospital for examination as soon as possible. If the situation is not serious or there are no abnormalities for the time being, you can use uterotonics. and antibiotics. If the situation is serious or placenta residue is found, uterine curettage should be performed with antibiotics to remove the residue to promote uterine contractions. If the residue remains for too long, curettage can be performed under B-ultrasound and try to remove it all at once. After ruling out infections, placenta residue and other pathological changes, postpartum lochia can be treated with folk prescriptions or traditional Chinese medicine.
If the uterine contraction is poor, motherwort can be taken. Take 2 to 3 taels each time, add brown sugar and boil it in water.
Motherwort can activate blood circulation, regulate menstruation and detoxify, so it has become a specialty medicine in obstetrics and gynecology, especially for uterine contraction.
Recipe 1
Composition: 18 grams of Bupleurum, 25 grams of American ginseng, 10 grams of Angelica sinensis, 10 grams of Ligusticum chuanxiong, 10 grams of peach kernel, 5 grams of ginger, 25 grams of motherwort, and ginger. 10 grams, 5 grams of licorice, 12 grams of red peony root, 12 grams of jujube, decoct and take.
Function: Regulate qi and dispel cold, reconcile Chong and Ren, activate blood circulation and remove blood stasis, warm the palace and stop bleeding.
Indications: persistent lochia. Symptoms include lochia, which is dripping, astringent and stagnant, coming and going, dark color, and slight distension and pain in the lower abdomen.
Recipe 2
Composition: 12 grams of raw rehmannia, 12 grams of cooked rehmannia, 12 grams of white peony root, 15 grams of Ophiopogon japonicus, 20 grams of yam, 12 grams of forsythia, and 10 grams of Cyperus rotunda. , 6 grams of Acosta, 20 grams of Ligustrum lucidum, 24 grams of Eclipta, 15 grams of cuttlefish bone, 12 grams of madder root, 20 grams of winter melon kernels, and 3 grams of Amomum villosum, decoction in water and take.
Function: Nourishes yin, clears away heat, regulates qi, regulates flow and stops bleeding.
Indications: Postpartum lochia caused by blood heat and qi stagnation, loss of Chong and Ren. Symptoms include abdominal distension, persistent lochia, yellow urine, dry mouth, red tongue without coating, and stringy and rapid pulse.
Prevention and prognosis
(1) Prevention of postpartum lochia
1. Actively treat various pregnancy diseases before delivery, such as pregnancy-induced hypertension syndrome , anemia, vaginitis, etc.
2. For those with premature rupture of membranes and long labor, antibiotics are given to prevent infection.
3. After delivery, carefully check whether the placenta and fetal membranes are complete, and deal with them promptly if there are any residues. Check the placenta and fetal membranes. Lay the placenta flat with the maternal side facing up. Pay attention to whether the leaves can be combined and whether there are any defects. Then lift up the fetal membranes to check whether they are complete. At the same time, pay attention to whether there are any abnormal blood vessels passing through the fetal membranes. If there are severed blood vessels, it means that there may be "accessory placenta" remaining in the uterus. If the placenta is incomplete or most of the fetal membranes remain, it must be removed from the uterine cavity with bare hands or instruments under strict disinfection to prevent postpartum hemorrhage or infection. If a small part of the fetal membranes remains, uterotonic agents can be used after delivery to promote their natural expulsion.
4. Continue breastfeeding, which is beneficial to uterine contraction and the discharge of lochia.
(2) The prognosis of postpartum lochia
If treated promptly, the patient will recover quickly and the lochia will be clear. If treatment is not timely, or the body's resistance is poor, a small amount of bleeding may lead to severe infection in the puerperium or chronic pelvic inflammatory disease. Severe infection may lead to massive bleeding after endometrial necrosis, which is seriously life-threatening and may lead to cancer in the long run. .
In fact, women should pay attention to several things in daily life after childbirth to prevent lochia from continuing.
1. Observe the color, amount and smell of lochia every day after delivery. Normal lochia should be odorless but smell of blood. If there is a stinky smell, it may be that there is fetal material in the uterus. Residues should be treated immediately.
2. Regularly measure uterine contractions. If you find poor contractions, you should see a doctor to prescribe uterotonics.
3. Keep the vagina clean. Due to the discharge of lochia, women should change sanitary napkins frequently to keep them fresh. It is best to temporarily prohibit sexual intercourse to avoid infection.
4. Postpartum lochia persists. If you suspect that the placenta remains, you should go to the hospital in time and receive treatment under the guidance of a doctor.