A 23-yrs-old woman (aravida 2, para 2) calls her physician 7 days postpartum because she is concerned that she is still bleeding from the vagina. It would be appropriate to tell this woman that it is normal for bloody lochia to last up to? (LQ)
a. Bloody lochia can persist for up to 2 weeks without indicating an underlying pathology; however, if bleeding continues beyond 2 weeks, it may indicate placental site sub involution, retention of small placental fragments, or both. At this point, appropriate diagnostic and therapeutic measures should be initiated.
b. The physician should first estimate the blood loss and then perform a pelvic examination in search of uterine subinvolution or tenderness.
c. Excessive bleeding or tenderness should lead the physician to suspect retained placental fragments or endometritis.
d. A larger than expected but otherwise asymptomatic uterus supports the diagnosis of sub involution.