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Lochia rubra (or cruenta) is the first discharge, composed of blood, shreds of fetal membranes, decidua, vernix caseosa, lanugo and membranes. It is red in color because of the large amount of blood it contains. It lasts 1 to 4 days after birth, before easing to light "spotting". [7] [unreliable source?]
An increase in vaginal discharge is common during pregnancy due to hormonal changes. The discharge, known as leukorrhea, is usually thin and milky white. However, if the discharge changes color or consistency significantly, it is essential to consult a healthcare provider. [9]
Normal vaginal discharge may have a thin, watery consistency or a thick, sticky consistency, and it may be clear or white in color. [1] [2] Normal vaginal discharge may be large in volume but typically does not have a strong odor, nor is it typically associated with itching or pain. [3]
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It is usually a non-pathological symptom secondary to inflammatory conditions of the vagina or cervix. [5] Leukorrhea can be confirmed by finding >10 WBC per high-power field under a microscope when examining vaginal fluid. [6] Vaginal discharge is normal, and causes of change in discharge include infection, malignancy, and hormonal changes.
Cervix with a bluish-violet discolouration. Chadwick sign is a medical clinical sign characterised by the bluish-violet discolouration of the mucous membranes of the vulva, vagina (particularly on the anterior vaginal wall), and the cervix, resulting from venous congestion due to increased blood flow as part of the maternal physiological changes in pregnancy.
Because pH in the upper vagina is normally acidic (pH 3.8–4.5), a vaginal pH test showing a pH of more than 4.5 strengthens a suspicion of rupture of membranes in case of clear vaginal discharge in pregnancy. [7] Other tests for detecting amniotic fluid mainly include nitrazine paper test and fern test. [8]
The cervix remains soft after birth. The vagina contracts and begins to return to the size before pregnancy. For four to six weeks of the postpartum period the vagina will discharge lochia, a discharge containing blood, mucus, and uterine tissue. [11]