What should I pay attention to if I still have red lochia after delivery?

Lochia is the decidua and blood of the uterus that are discharged through the vagina after a normal delivery. It is usually discharged three weeks after delivery. It is bright red in the early stage and dark red or brown in the later stage. It has a fishy smell but no odor. Red or bright red lochia usually appears in the first week and the amount is large, but it decreases and turns into a small amount of dark brown as the mother's body gradually recovers.

What to do if postpartum lochia is bright red

During the postpartum period, the weight of the uterus will decrease from 1000g to 50~60g, and the volume will continue to shrink, returning to its pre-pregnancy size after 6 weeks. The quality of uterine involution can be estimated from the descent of the uterine fundus and the condition of lochia. Therefore, lochia is a mirror of maternal health. We must learn to observe our own lochia. If we find any problems, we must go to the hospital as soon as possible. If the lochia has a foul odor, or there is too much red or white lochia and it lasts too long, repeatedly, it means that the lochia is abnormal. Abnormal lochia is often a manifestation of certain diseases, with postpartum bleeding and infection being the most common.

What are the abnormal conditions of postpartum lochia?

1. If the color of postpartum lochia has become lighter, and bright red blood appears again, and it exceeds the menstrual volume, you should go to the hospital for treatment.

2. If the lochia is still bloody, large in amount, and accompanied by a foul odor 2 weeks after delivery, and sometimes contains rotten meat-like substances or fetal membrane-like substances, then you should consider that there may be residual placenta or fetal membranes in the uterus, and heavy bleeding may occur at any time. You should go to the hospital for diagnosis and treatment immediately.

3. When puerperal infection occurs after delivery, it can cause endometritis or myometritis. At this time, the mother will have symptoms such as fever, lower abdominal pain, increased lochia and bad odor. The lochia at this time not only has a foul odor, but also is not the normal bloody or serous color, but a turbid, dirty earthy brown color.

4. The amount of vaginal bleeding is significantly greater than the amount of menstruation, accompanied by dizziness and palpitations. This indicates postpartum hemorrhage and you need to go to the hospital immediately.

5. If red lochia recurs or becomes more and more after delivery, and is occasionally mixed with fresh blood clots, in addition to the possibility of placental retention and poor uterine involution, you should also be alert to trophoblastic tumors. This is a highly malignant cancer that often occurs after hydatidiform mole, and in about 20% of cases it also occurs simultaneously with full-term pregnancy. A few days after a normal pregnancy and delivery, the urine or blood chorionic gonadotropin will turn negative. If it is still positive and accompanied by repeated bloody lochia, you should be highly vigilant.