A postpartum woman is examined daily by her resident. Which sequence correctly describes the normal changes in lochia over the first two weeks?

• A All three types appear simultaneously and resolve together by day 6
• B Lochia serosa days 1-3, rubra days 4-9, alba from day 10
• C Lochia alba days 1-3, rubra days 4-9, serosa from day 10
• D Lochia rubra days 1-3, serosa days 4-9, alba from day 10 ✓

Explanation

Lochia follows a fixed colour sequence reflecting healing of the placental site. Lochia rubra, red and blood-tinged, lasts about the first 3 to 4 days. It is replaced by lochia serosa, pinkish-brown with leucocytes and decidua, until roughly day 10. Lochia alba, white-yellow and mucus-rich, then continues up to 4 to 6 weeks. The distractor B reverses the order, but serous discharge cannot precede the bloody stage because early discharge is dominated by fresh blood from the raw placental bed.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.