Study On The Normal Postpartum Lochia Loss Duration And The Impact Factors

Objective:By filling out the questionnaire of the postpartum lochia loss and some other information about the subjects to know about the mode of maternal postpartum lochia and investigation of maternal changes in postpartum lochia, to establish normal puerperal women lochia duration range as well as part of a clear effect of postpartum lochia duration factor. To provide correct cognition of postpartum lochia for clinicians and puerperal women, popularize knowledge of the health postpartum lochia, eliminate the lochia for doubts and to identify puerperium pathological conditions provide an important reference value. The definition of lochia for postpartum is with endometrial shedding, containing blood and decidual necrosis tissue discharged from the vagina in textbooks. Normal lochia has the smell of blood, but do not smell stinky, lasting for 4-6weeks, about a total of 250-500 ml, according to its color, different contents and duration,lochia points for lochia rubra, lochia serosa, lochia alba. With subinvolution of uterus or residual placenta, caul remained or infection, lochia rubra would last for a long time and smell stinky. In the clinical work of lochia with textbooks and literature described the situation there are big differences.Because of individual differences,maternal age,primiparas and multiparous, fetal weight, delivery and infant feeding pattern will lead postpartum lochia to many forms. Therefore, this paper for different factors affecting the normal postpartum lochia for investigation and statistics, improves the information to provide reference can be the basis for evidence-based medicine for patients and our clinical work.Methods:Through the form of questionnaire and analyzed retrospectively investigated maternal normal lochia duration and age, the factors of maternal or early maternal, fetal weight,mode of delivery, feeding pattern and for the duration of postpartum lochia has effect or not. Investigation object inclusion criteria:(1) gestational age greater than or equal to 37weeks;(2) single live births;(3) without severe obstetric complications;(4) no long-term use of hormone or accept immunotherapy;(5) delivery without premature rupture of membranes, placenta residue;(6) in puerperium unconsolidated infection;(7) to complete a matching questionnaire.First according to the mode of delivery divided into vaginal delivery and cesarean section delivery group, and then the two groups were divided into:(1) in accordance with maternal the childbearing age is divided into: age > 35 years old group, 25-35 years old(included 35 year old)group, age less than or equal to 25 years of age group;(2) according to maternal whether for primiparas divided into: primiparas and multiparous group;(3) in the fetal body weight divided into: birth weight is more than or equal to 4000 g group,neonatal birth weight < 4000 g group;(4) according to infant feeding pattern is divided into: pure breast feeding group and mixture feeding group and artificial feeding group.Exclusion criteria:(1) the existence of uterine malformation;(2) complicated with severe internal and external diseases(tumor, autoimmune diseases, cardiovascular disease,blood disease, etc.);(3) with myoma of uterus;(4) of the patients whose activities are limited;(5) in puerperium for other reasons need to patients undergoing surgery or a large number of drug treatment. According to the questionnaire results of the statistical analysis of each group of postpartum lochia duration and income data for statistical analysis, each set of data with X ± 1.96 S said, based on the statistical features of selection different statistical test methods to test each set of data between groups and within groups. Each inspection standards are α =0.05.Results:(1) the total number of vaginal delivery mean maternal postpartum lochia is 34.11 +6.42 days, cesarean section average postpartum lochia total time for 43.02 + 6.07 days and after vaginal delivery days of lochia rubra, lochia alba more than cesarean section and cesarean section of lochia serosa days and the total number of longer than vaginal delivery.(2) the age above 35 years old group of maternal slurry days lochia, lochia alba days and the total number of days were longer than those of less than or equal to 25 years old group and 25-35 years old group.(3) at the beginning of the maternal lochia rubra duration, lochia serosa duration,lochia alba duration and the total duration were longer than that of parous women.(4) lochia rubra duration, lochia serosa duration and the total number of duration,the maternal neonatal weight ≥ 4000 g were longer than the other.(5) lochia rubra duration, lochia serosa duration and the total number of duration,exclusive breastfeeding mothers were less than artificial feeding and mixed feeding mothers.(6) lochia rubra repeated in the vaginal delivery group of women accounted for84.49% and accounted for 60.63% in cesarean section group. But there were no significant difference between repeated lochia and age, blood fetal weight and feeding pattern.(7) the study of postpartum lochia the total duration over 42 days of 118 people,accounting for 25.48% of the total number and caesarean lochia total number of more than 42 days accounted for cesarean section in the total number of 50.63%.Conclusion:1.the duration of lochia may be associated with mode of delivery, maternal age,feeding pattern,parity and birth weight;2.elder primipara, macrosomia, non exclusive breastfeeding, splits the palace production and lochia persisted time are positively related, may be the main factors leading to prolonged lochia;3.the repeated lochia rubra phenomenon(like menstrual) may be the physiologicalsignal for the end of lochia, vaginal delivery mode may be one of the main factors leading to lochia rubra repeat;4.postpartum lochia that lasting for more than 42 days defined as net lochiostasis or subinvolution of uterus is not appropriate.