Weekly flow

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Under lochia ( lochia of ancient Greek λόχος lóchos , German , birth ' ) refers to the wound secretion of human uterus after birth , resulting from the vagina of the new mother is secreted.

Origin and course

After the birth of the placenta (placenta) and fetal membranes , the uterine lining from a wound surface. While the Eihauthaftstelle nearly smooth, the placenta affixed spot is a rough wound area, depending on the size of the placenta has cm a diameter of about 12.5. This wound surface is covered with thrombi , remains of glands and stumps of the villi. Granulocytes , lymphocytes and phagocytes migrate into this wound area, dissolve the tissue remnants and phagocytize them. In addition, with fibrin , a leukocyte wall or "protective wall" against pathogenic germs is formed. With the help of what is known as after labor , this now dead ( necrotic ) tissue is excreted, allowing the wound to heal. This "excreted tissue" corresponds to the weekly flow. This "regression" is also supported by the release of oxytocin when the baby is breastfeeding . Two weeks after birth, the wound area in the uterus has shrunk to 5 cm, epithelialization begins three weeks after birth, and wound healing is complete after six to eight weeks.

Stages of the weekly flow

In the first time after birth, the lochia are bloody and persistent , then rapidly decrease in quantity and change color and consistency from slimy-red (also pink), brownish (like old blood) and then to amber-like discharge. Weekly river has a slightly musty, strong odor. The amount and period of bleeding can vary widely, with a normal rate of 200–500 ml. The weekly flow, also known as the "mirror of wound healing", usually lasts for two to six weeks.

  • Lochia rubra : In the first one to three days after birth, the weekly flow is continuous , red and liquid. Its smell is described as sweet and bland. At this point in time, the weekly flow essentially consists of blood, remnants of egg skin and decidua, vernix flakes , lanugo hairs and child woodpecker can be mixed in.
  • Lochia fusca : At the end of the first week after the birth, the weekly flow decreases, becomes brownish and thin. The weekly flow now contains serum, lymph and granulocytes.
  • Lochia flava : At the end of the second week after the birth there is little, dirty yellow, “creamy” weekly flow. Liquefied, necrotic tissue that is mixed with bacteria and mucus is shed.
  • Lochia alba : At the end of the third week there are only small amounts of whitish, watery fluid.
  • After four to six weeks, the weekly flow stops. It is assumed that the skin adherents will heal after about four weeks and the placental wound surface after six to eight weeks.

Contrary to the opinion of older specialist literature, the lochia are no more infectious than normal menstrual bleeding. They consist of blood , white blood cells ( leukocytes ), serous fluid, and vaginal secretions . Remaining remains of the membranes (chorion and amnion) and decidua may also be mixed in. The lochia contains numerous germs, however, the majority of which is non-pathogenic (non-disease-causing). Lochia are only infectious if they are purulent and contain a high content of pathogenic germs, such as Staphylococcus aureus or β-hemolytic streptococci . An indication of such an infection is a fishy or purulent odor. The woman who has recently given birth develops a high fever with pain in the lower abdomen.

If the weekly flow stops prematurely and suddenly, it may be a weekly flow backlog (Lochialstau). This should be corrected so that any residue left in the uterus cannot become infected (risk of endometritis ).

literature

  • Christine Mändle, Sonja Opitz-Kreuter and Andrea Wehling: The midwifery textbook on practical obstetrics. ISBN 3-7945-1765-2

Web links

Wiktionary: Lochien  - explanations of meanings, word origins, synonyms, translations