ABSTRACT
-The objective of this paper is to determine the characteristics of each phase of
lochia and how these may be influenced by a number of obstetric variables. Thirty-nine
healthy women who had spontaneous vaginal delivery following uncomplicated pregnancy
volunteered to complete a diary sheet immediately postpartum. The women were instructed
to assess the color of their lochia by a color slide with differential gradation from
dark red to white. The color was labeled as rubra (red, red-brown), serosa (brown-pink,
brown), or alba (yellow, white). The overall duration of lochia was 36.0 ± 7.5 days
(range 17 to 51 days, median 37 days). Three types of lochia color patterns were identified:
type 1-rubra→serosa→alba sequence (n = 20); type 2-rubra→serosa→alba sequence with
prolonged rubra phase and short serosa and alba phases (n = 11); and type 3-with two
rubra phases (rubra→serosa/alba→rubra→serosa/alba sequence with near-equal duration
of each phase) (n = 8). The rubra phase lasts 12.1 ± 6.7 days in type 1, 24.8 ± 5.0
days in type 2, and 5.5 ± 2.5 days (the first rubra) in type 3 pattern (p < 0.05).
There was a higher proportion of lactating women among women with type 1 pattern as
compared with type 2 (11/20 and 2/11, p < 0.05, respectively). Women with type 2 pattern
were of higher parity (2.8 ± 1.3) as compared with those with type 1 (1.8 ± 0.8) (p
< 0.05). There were no significant differences in infants' birth weight between the
various color types (3276.0 ± 379.8 g, 3564.4 ± 737.9 g, and 3080.0 ± 180.0 g for
type 1, type 2, and type 3, respectively. There were no significant differences in
overall duration of lochia or gestational age at delivery between the various color
types. The results confirm the clinical impression that lochia persists longer than
classically reported and is of diverse patterns. Three unique types of color patterns
were identified. Type 1 is the most prevalent and is associated with prolonged breast
feeding and thus can be considered as the classic type. Type 2 is associated with
short or no breast feeding and higher parity. Type 3 may be a variant of type 2. We
suggest that traditional teaching on lochia characteristics needs reappraisal.
KEYWORD
Peurperium - lochia - labor
