Twelve days after an uncomplicated spontaneous vaginal delivery, a 26-year-old woman reports pinkish-brown vaginal discharge without foul odor. She is afebrile and the uterus is well involuted. The most appropriate interpretation is:

• A Puerperal metritis needing antibiotics
• B Secondary postpartum hemorrhage requiring curettage
• C Lochia alba indicating delayed involution
• D Normal lochia serosa ✓

Explanation

Lochia rubra lasts 3 to 4 days, lochia serosa (pinkish brown, containing serum, leukocytes and decidual debris) persists until roughly the tenth to twelfth day, and lochia alba follows for up to 4 to 6 weeks. Afebrile status, absence of odor and good involution exclude metritis. Fresh red bleeding at this stage, not pinkish-brown discharge, would raise concern for retained products causing secondary hemorrhage.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.