Obstetrics & Gynaecology · Puerperium, Rh Isoimmunization and Cesarean Section

On postpartum day 7, a woman notes her vaginal discharge has become pinkish brown and less copious than in the first few days. Which statement about normal lochial changes is correct?

  • A Lochia serosa persists until about the fourth week postpartum
  • B Lochia rubra normally lasts 3 to 4 days, followed by lochia serosa up to about day 10
  • C Lochia alba begins around the fourth day and contains abundant red blood cells
  • D Offensive smell of lochia at any stage is an expected finding of normal involution
Correct answer: B. Lochia rubra normally lasts 3 to 4 days, followed by lochia serosa up to about day 10

Explanation

Lochia rubra lasts 3 to 4 days, lochia serosa (pinkish brown) from roughly day 4 to day 10, and lochia alba (whitish, leucocyte rich) thereafter, ceasing by 4 to 6 weeks. Lochia serosa does not persist to week four, and lochia alba is leucocyte rich rather than blood rich. Offensive smelling lochia signals endometritis or infection, not normal involution.

Reference: DC Dutta's Textbook of Obstetrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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