Bloody lochia

Introduction After maternal delivery, the decidua of the uterine decidua, especially the placenta attachment, is shed. The color of the sputum is bright red, containing a lot of blood, and the amount is large. Sometimes there are small blood clots. A small amount of fetal membranes and necrotic decidua are discharged through the vagina. .

Cause

Within 3-4 weeks after the delivery of the fetus, the tissue, mucus and blood discharged from the uterine cavity are mixed together and discharged from the vagina, commonly known as lochia.

In the TCM classics "Fetal Birth Heart Law" mentioned: "Because the time of injury to the menstrual blood, lack of deficiency, can not be taken, or the blood is not exhausted, then the blood is difficult, and the next time, more than a long time. Therefore, the lochia is more than related to "deficiency" or "blood". Normal lochia has a bloody smell, but no odor, lasting 4 to 6 weeks, the total amount is about 250ml-500ml, and the individual difference is large. In the first week after delivery, the amount of lochia is more, the color is bright red, and it contains a lot of blood, small blood clots and necrotic decidua tissue, called red lochia. After 1 week to half a month, the amount of blood in the lochia is reduced, and more is the necrotic decidua, cervical mucus, vaginal secretions and bacteria, making the lochia into a light red serum. Sexual lochia. Chinese medicine believes that postpartum injury to its menstrual blood, lack of deficiency, can not be taken, or blood is not exhausted, then blood is difficult, and down, for a long time.

The reason why women's postpartum lochia is not clean is generally related to physical weakness, mostly qi deficiency and blood stasis or blood heat. Women with qi deficiency have insufficient blood gas before delivery, plus blood loss during childbirth, and they have not adjusted their tonics after childbirth, so that they can not take blood by spleen and spleen, and bloody sputum is so bad that blood is not smooth; women with blood heat are due to childbirth. Blood loss and yin deficiency are bloody and hot.

an examination

Related inspection

Gynecological ultrasound examination gynecological examination

Observe if your lochia is normal. Some lochia are abnormal and should be noticed.

After the postpartum, the endometrium (especially the endometrium where the placenta is attached) falls off, and the mucus secreted by the uterus also flows out from the vagina. This is the lochia. In the first week after delivery, the amount of lochia is more, the color is bright red, and it contains a lot of blood, small blood clots and necrotic decidua tissue, called red lochia. Normal lochia has some bloody smell, but it is not stinky. The total amount is about 500-1000 ml. Under normal circumstances, lochia is cleaned about 3 weeks after birth.

Differential diagnosis

Symptoms of bloody lochia

Prolonged duration of bloody lochia: The most prominent clinical manifestation of uterine incompleteness is the prolongation of bloody lochia, extending from normal only for 3 days to 7 to 10 days or even longer. If the disease is due to the placenta residue, the bloody lochia lasts for a long time, and the blood volume is also significantly increased. At this time, the lochia is often cloudy or accompanied by odor.

Lochia during puerperium: After the delivery of the uterus, the decidua of the uterine decidua, especially the placenta attachment, is detached from the decidua, containing blood, necrotic decidua and other tissues. After the postpartum lochia lasts for more than three weeks, it is still dripping, which is called postpartum lochia. Postpartum lochia is caused by labor and labor meridians, resulting in abnormal blood and blood, and more than 3 weeks after birth, there are still vaginal bleeding. It is equivalent to poor uterine involution, mild infection of the uterus, residual placenta and membrane. Under normal circumstances, the lochia is about 3 weeks after birth, and if it is not clean for more than 3 weeks, it is a pathological phenomenon. More or less, color or red or dark red or purple, or blood clots, or smelly or odorless; maternal often accompanied by back pain, lower abdomen bulge pain, sometimes fever, headache, joint pain Etc., gynecological examination can find that the uterus is getting old.

White lochia: thick and white. Contains a large number of white blood cells, necrotic tissue aponeurosis, epidermal cells and bacteria. White lochia lasted for 3 weeks and was clean.

Postpartum lochia is not clean and smelly: late postpartum hemorrhage is manifested as postpartum lochia that is not clean and smelly. Repeated or sudden vaginal bleeding can lead to anemia, shock and even life-threatening. Late postpartum hemorrhage refers to a large amount of bleeding in the uterus that occurs during the calving period after 24 hours of delivery, and the amount of bleeding exceeds 500 ml. The most common morbidity occurred 1 to 2 weeks after delivery, and it was late to 6 weeks after birth. Also known as puerperal bleeding. The incidence of late postpartum hemorrhage is closely related to the quality of prenatal care and obstetric quality. Have a history of lower abdominal pain, low fever or low postpartum fever.

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