Characteristics of normal lochia

The objective of this paper is to determine the characteristics of each pha se of lochia and how these may be influenced by a number of obstetric varia bles. Thirty-nine healthy women who had spontaneous vaginal delivery follow ing uncomplicated pregnancy volunteered to complete a diary sheet immediate ly postpartum. The women were instructed to assess the color of their lochi a 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 pattern s were identified: type 1-rubra-->serosa-->alba sequence (n = 20); type 2-r ubra-->serosa-->alba sequence with prolonged rubra phase and short serosa a nd alba phases (n = 11); and type 3-with two rubra phases (rubra-->serosa/a lba-->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 da ys 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 t ype 1 pattern as compared with type 2 (11/20 and 2/11, p < 0.05, respective ly). Women with type 2 pattern were of higher parity (2.8 +/- 1.3) as compa red with those with type 1 (1.8 +/- 0.8) (p < 0.05). There were no signific ant differences in infants' birth weight between the various color types (3 276.0 +/- 379.8 g, 3564.4 +/- 737.9 g, and 3080.0 +/- 180.0 g for type 1,ty pe 2, and type 3, respectively. There were no significant differences in ov erall duration of lochia or gestational age at delivery between the various color types. The results confirm the clinical impression that lochia persi sts longer than classically reported and is of diverse patterns. Three uniq ue types of color patterns were identified. Type 1 is the most prevalent an d 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 traditio nal teaching on lochia characteristics needs reappraisal.