Postpartum lochia turns white and then bleeds

We all say that it is not easy for mothers to be pregnant for ten months. It is inconvenient to walk or work with a big belly every day. Don’t think that it’s uncomfortable only when you are pregnant. It is not easy to take care of yourself after giving birth. You have to stay in bed for a month and avoid being exposed to wind or cold. And there may also be postpartum lochia. Postpartum lochia is a condition that may occur in pregnant women after childbirth and is a physiological change. Why does postpartum lochia turn white and then bleed?

Postpartum lochia refers to the discharge of blood, necrotic decidua and other tissues through the vagina along with the shedding of the uterine decidua after delivery. It is called lochia. It is a clinical manifestation of the parturient in the puerperium and is a physiological change. Lochia has a bloody smell but no odor. Its color and contents change over time. It usually lasts for 4 to 6 weeks and the total amount is 500 ml. If more lochia is still discharged after the above time, it is called prolonged lochia.

There are many reasons for prolonged lochia after delivery, such as endometritis; partial retention of the placenta and fetal membranes; myometritis or pelvic infection; uterine submucosal or intramural tumors; uterine adenomyoma; excessive retroversion or retroflexion of the uterus; excessive amniotic fluid and excessive placenta that weakens the uterine muscle contraction and affects uterine involution, etc. Postpartum uterine trophoblastic tumors can also cause uterine bleeding.

This disease belongs to the category of late postpartum hemorrhage. The main cause of the disease is incomplete uterine involution, when part of the placenta or fetal membrane remains or becomes infected, affecting uterine contraction and involution. Other systemic factors of the mother, such as chronic diseases, excessive blood loss, excessive fatigue, failure to recover physical fitness, or local factors such as excessive uterine expansion and uterine fibroids, can all affect incomplete uterine recovery. Secondly, after cesarean section, the uterine wall incision ruptures, bleeding is not completely stopped during surgery, or there is postoperative infection, which affects the recovery of the uterus and causes continuous bleeding.

Classification

Normal lochia is divided into three types according to its color, contents and time:

1. Bloody lochia

It is named because it contains a large amount of blood, which is bright red in color, large in amount, and sometimes contains small blood clots. Microscopically, a large number of red blood cells, necrotic decidua and a small amount of fetal membranes were seen. Bloody lochia lasts less than 3 days. The bleeding gradually decreases, the serous fluid increases, and turns into serous lochia.

2. Lochia

It is named because it contains a large amount of serous fluid and is light red in color. Microscopically, there are a lot of necrotic decidual tissues, intrauterine exudate, cervical mucus, a small amount of red blood cells and white blood cells, and bacteria. Serous lochia lasts for 4-14 days, the serous fluid gradually decreases, the number of white blood cells increases, and it turns into white lochia.

3. White lochia

It is named because it contains a large number of white blood cells, is white in color and has a viscous texture. Under the microscope, a large number of white blood cells, necrotic decidual tissue, epidermal cells and bacteria were seen. The white lochia lasts for about 3 weeks.

Although every parturient has lochia, the amount discharged is different for each person, and the average total amount can reach 500 to 1000 ml. The duration of discharge varies from woman to woman. Normal women usually need 2 to 4 weeks, while a few women can last 1 to 2 months.

When a child is breastfeeding, sucking the nipple can cause reflex uterine contractions, which is beneficial to the discharge of lochia in the uterine cavity.

Clinical manifestations

1. Tissue residue

It may be due to advanced pregnancy, uterine malformation, uterine fibroids, etc., or it may be due to the unskilled operation operator, resulting in incomplete removal of the pregnancy tissue, causing some tissue to remain in the uterine cavity. At this time, in addition to the unclean lochia, the amount of bleeding varies, with blood clots inside, and is accompanied by intermittent abdominal pain.

2. Uterine infection

Uterine infection may be caused by taking a bath in a tub after childbirth or abortion, using unclean sanitary napkins, having sexual intercourse shortly after childbirth or abortion, or by the operator not sterilizing the procedure properly. At this time, the lochia has a foul odor, there is tenderness in the abdomen, and it is accompanied by fever. A blood test shows an increase in the total white blood cell count.

3. Uterine atony

It may be due to failure to get enough rest after delivery, or due to poor health or prolonged delivery or cesarean section, which may lead to weak uterine contractions and continuous lochia.

Since the symptoms and treatments vary, you are reminded to go to the hospital in time and ask the doctor to find out the cause of the lochia and treat it accordingly.