Physically, when the size of the uterus is compared to the state immediately after delivery, it shrinks back to 1/10-th of the size during pregnancy within only 6 weeks.
There vaginal discharge, which is reddish-brown, (medically called the “lochia”) for 3 to 4 days, which turns into a malodorous, bloody and watery discharge (“lochia serosa”) for 3 weeks after the delivery. After this the discharge often turns yellowish/white (“lochia alba”) for another 1 or 2 weeks Ref. 18, p. 692).
However, in some women retained placenta from the delivery, at least as piece of it, may still be present in the uterine cavity, in which case the uterus has problems contracting completely and new red vaginal bleeding would start about 7 to 14 days after the delivery. This is abnormal and requires an urgent assessment by the physician or obstetrician to prevent the development of a hydatidiform mole or of a choriocarcinoma.
The physician usually orders an ultrasound, which would show whether or not retained tissue is found in the uterus. If there is, a brief daycare procedure in the hospital (uterine evacuation and curettage) would have to be arranged. If the uterine cavity is empty, oxytocin can be given intravenously or methylergonovine (Methergine) intramuscularly. The latter substance cannot be used in patients with heart problems or hypertension.
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