LOCHIATIONS AND POSTPARTUM LEAKS

Definitions

To learn more about the phenomenon of postpartum losses, it is good to familiarize yourself with some specialized terms:

afterbirth: it is the natural phenomenon of detachment and expulsion of the placenta and all the fetal appendages, which normally occurs within 15-30 minutes of delivery; when anomalies arise in this phase we speak of secondary pathologies (eg failure to detach the placenta and / or complete detachment without expulsion). In case of afterbirth pathologies (often related to placenta previa problems or other placental abnormalities), postpartum bleeding may be excessive; in this case, doctors may administer drugs intravenously or intramuscularly to help stop the "haemorrhage and / or to stimulate uterine contractions which allow the expulsion of the placenta and facilitate the stop of the haemorrhage.

post-partum pathologies: this term includes post-partum haemorrhages due to inadequate activation of physiological haemostasis mechanisms; in these cases, the body of the pregnant woman is unable to stop the loss of blood resulting from the detachment of the placenta.

postpartum haemorrhage (EPP): doctors use this term when the loss of blood after delivery is excessive, i.e. greater than 500ml in case of vaginal birth and 1000ml in case of caesarean section; post-partum haemorrhage is considered serious when it exceeds 1500ml, while above 2500ml we speak of greater blood loss;

lootations (or lochi): losses of blood, mucus and cellular elements that typically accompany the first 3-6 weeks after childbirth (they tend to last longer in breastfeeding women, and vice versa); this phenomenon is due to the wound left by the detachment of the placenta and to the gradual return of the uterus to pre-pregnancy dimensions, with phenomena of cell digestion and expulsion of mucus, liquid residues and fetal membranes. Lochiations have essentially haematic characteristics, with traces of clots, and therefore appear dark red in color Subsequently, the lochings tend to take on a gradually paler color up to yellowish-white, and a creamy consistency.
The phenomenon of lochiations is closely linked to uterine contractions (called in this phase "uterine bites"), which will therefore continue to accompany the woman even for a few weeks after childbirth. Generally these contractions become more intense and annoying from the second birth onwards; they are also favored by breastfeeding, thanks to the action of oxytocin, whose secretion is stimulated by the baby's sucking.

head of birth: it is the reappearance of the menstrual flow, or the first menstruation after the birth of the baby. Generally, if the woman has not breast-fed, the head of the ward appears within a very short time from the cessation of the lochia; vice versa, in nurses the head of the birth occurs after a longer period.

Advice

Since the lochi represent a fertile ground for the development of bacteria, it is important to practice "adequate intimate hygiene of the external genitals, washing them carefully with specific detergents at each change of sanitary napkin; unless otherwise advised by medical advice, it is good to avoid the use of sanitary pads. internal, because they could favor the stagnation and proliferation of germs. In this regard, it should be considered that the changes undergone by the "uterus in the immediate post-partum" also have the purpose of counteracting the pathogens entered during childbirth, thanks to the massive infiltration of white blood cells.

If the patches give off a particularly unpleasant odor, if they take on a brownish-green color, if they are particularly abundant or if their color suddenly changes to bright red, it is advisable to consult your gynecologist or general practitioner immediately.

Sexual intercourse is not recommended for the entire duration of the lochia, or at least in the first phase, as it could facilitate the establishment of infectious processes.