Lochiorrhea

Lochiorrhea

Lochiorrhea is a medical condition characterized by the excessive or prolonged discharge of lochia, which is the vaginal discharge that occurs after childbirth. This condition can be a concern for postpartum women and requires careful monitoring and management to prevent complications.

Overview

Lochia is a normal postpartum discharge that consists of blood, mucus, and uterine tissue. It typically lasts for about four to six weeks after delivery, gradually changing in color and consistency from bright red to pink, then to white or yellow. Lochiorrhea, however, refers to the abnormal continuation or excessive flow of lochia beyond the expected postpartum period.

Causes

Lochiorrhea can be caused by several factors, including:

• Retained placental fragments: If pieces of the placenta remain in the uterus after delivery, they can cause prolonged bleeding and discharge.
• Infection: An infection in the uterus, known as endometritis, can lead to increased lochial discharge.
• Subinvolution of the uterus: This occurs when the uterus does not return to its pre-pregnancy size at the expected rate, often due to retained tissue or infection.
• Hormonal imbalances: Hormonal changes postpartum can affect the normal process of uterine involution and lochia discharge.

Symptoms

The primary symptom of lochiorrhea is the persistence of lochia beyond the typical postpartum period. Other symptoms may include:

• Foul-smelling discharge
• Fever or chills, indicating possible infection
• Abdominal pain or tenderness
• Heavy bleeding or passage of large clots

Diagnosis

Diagnosis of lochiorrhea involves a thorough medical history and physical examination. Additional diagnostic tests may include:

• Ultrasound: To check for retained placental tissue or other abnormalities in the uterus.
• Blood tests: To assess for signs of infection or anemia.
• Cultures: To identify any bacterial infection present in the uterine lining.

Treatment

Treatment of lochiorrhea depends on the underlying cause:

• Medications: Antibiotics may be prescribed if an infection is present. Uterotonics can be used to help the uterus contract and expel retained tissue.
• Surgical intervention: In cases of retained placental fragments, a procedure such as dilation and curettage (D&C) may be necessary to remove the tissue.
• Supportive care: Monitoring and managing symptoms, such as pain and bleeding, are important aspects of care.

Prevention

Preventive measures for lochiorrhea include:

• Ensuring complete delivery of the placenta during childbirth.
• Monitoring for signs of infection postpartum.
• Regular postpartum check-ups to assess uterine involution and lochia discharge.

Prognosis

With appropriate treatment, the prognosis for women with lochiorrhea is generally good. Early intervention can prevent complications such as severe infection or significant blood loss.

Also see

• Postpartum period
• Endometritis
• Uterine involution
• Retained placenta

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