Physiological Maternal Changes during the Postpartum Period (Involution)

Lochia

1. Description: Discharge from the uterus that consists of blood from the vessels of the placental site and debris from the decidua
2. Assessment:
1. Scant: less than 2.5 cm (<1 inch) on menstrual pad in 1 hour
2. Light: Less than 10 cm (<4 inches) on menstrual pad in 1 hour
3. Moderate: Less than 15 cm (<6 inches) on menstrual pad in 1 hour
4. Heavy: Saturated menstrual pad in 1 hour
5. Excessive: Menstrual pad saturated in 15 minutes
6. The discharge should smell like normal menstrual flow.
7. Discharge decreases daily in amount.
8. Discharge may increase with ambulation.

• Color of Lochia:
• Rubra is bright red discharge that occurs from delivery to day 3.
• Serosa is brownish pink discharge that occurs from days 4 to 10.
• Alba is white discharge that occurs from days 11 to 14.

Source: Saunders Comprehensive Review for the NCLEX-RN® Examination, 6th Edition By Linda Anne Silvestri, PhD, RN