Puerperal loss (lochia) in women with or without inherited bleeding disorders

Published:April 26, 2010DOI:


      To assess the quantity and duration of lochia in women with or without inherited bleeding disorders and to identify factors that influence lochial loss.

      Study Design

      Pictorial blood assessment chart was completed by 115 pregnant women (21 with or carriers of inherited bleeding disorder and 94 without bleeding disorder) using standardized sanitary products.


      The median duration of lochia was significantly longer in women with (or carriers of) inherited bleeding disorder (39 days; range 21–58) compared with women without bleeding disorder (31 days; range, 10–62; P = .03); however, the median lochial loss were similar (441 mL; range, 135–1290 vs 429 mL; range, 112–1295; P = .59). Long labor and instrumental delivery were associated with heavier lochia.


      Pictorial blood assessment chart is potentially a useful tool in the assessment of lochia. Women with inherited bleeding disorders experience longer period of lochia compared with women without bleeding disorder. Labor duration and mode of delivery influence lochial loss.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Oppenheimer L.W.
        • Sherriff E.A.
        • Goodman J.D.
        • Shah D.
        • James C.E.
        The duration of lochia.
        BJOG. 1986; 93: 754-757
        • Visness C.M.
        • Kennedy K.I.
        • Ramos R.
        The duration and character of postpartum bleeding among breast-feeding women.
        Obstet Gynecol. 1997; 89: 159-163
        • Sherman D.
        • Lurie S.
        • Frenkel E.
        • Kurzweil Y.
        • Bukovsky I.
        • Arieli S.
        Characteristics of normal lochia.
        Am J Perinatol. 1999; 16: 399-402
        • Marchant S.
        • Alexander J.
        • Garcia J.
        • Ashurst H.
        • Alderdice F.
        • Keene J.
        A survey of women's experiences of vaginal loss from 24 hours to three months after childbirth (the BLiPP study).
        Midwifery. 1999; 15: 72-81
        • The World Health Organization multinational study of breast-feeding and lactational amenorrhea: IV, postpartum bleeding and lochia in breast-feeding women
        World Health Organization Task Force on Methods for the Natural Regulation of Fertility.
        Fertil Steril. 1999; 72: 441-447
        • James A.H.
        • Jamison M.G.
        Bleeding events and other complications during pregnancy and childbirth in women with von Willebrand disease.
        J Thromb Haemost. 2007; 5: 1165-1169
        • Kadir R.A.
        • Lee C.A.
        • Sabin C.A.
        • Pollard D.
        • Economides D.L.
        Pregnancy in women with von Willebrand's disease or factor XI deficiency.
        BJOG. 1998; 105: 314-321
        • Kadir R.A.
        • Economides D.L.
        • Braithwaite J.
        • Goldman E.
        • Lee C.A.
        The obstetric experience of carriers of haemophilia.
        BJOG. 1997; 104: 803-810
        • Wyatt K.M.
        • Dimmock P.W.
        • Walker T.J.
        • O'Brien P.M.
        Determination of total menstrual blood loss.
        Fertil Steril. 2001; 76: 125-131
        • Higham J.M.
        • O'Brien P.M.
        • Shaw R.W.
        Assessment of menstrual blood loss using a pictorial chart.
        BJOG. 1990; 97: 734-739
        • Janssen C.A.
        • Scholten P.C.
        • Heintz A.P.
        A simple visual assessment technique to discriminate between menorrhagia and normal menstrual blood loss.
        Obstet Gynecol. 1995; 85: 977-982