Visness C M, Kennedy K I, Ramos R
Contraceptive Use and Epidemiology Division, Family Health International, Research Triangle Park, North Carolina, USA.
Obstet Gynecol. 1997 Feb;89(2):159-63. doi: 10.1016/S0029-7844(96)00482-6.
To examine the postpartum bleeding experience of a cohort of breast-feeding women and to compare it with the conventional definition of lochia.
Four hundred seventy-seven experienced breast-feeding women in Manila, the Philippines, were followed prospectively from delivery and recorded vaginal bleeding in a menstrual diary. The median duration of lochia was calculated using survival analysis. In addition, all bleeding separate from lochia within the first 8 weeks postpartum was noted.
The median duration of lochia was 27 days and did not vary by age, parity, sex or weight of the infant, breast-feeding frequency, or level of supplementation. More than one-fourth of the women experienced a bleeding episode separated from the original lochial flow by at least 4 bleeding-free days and beginning no later than postpartum day 56. Ten breast-feeding women may have had their first menstrual bleed before day 56.
Lochia lasted substantially longer than the conventional assumption of 2 weeks. It was common for postpartum bleeding to stop and start again or to be characterized by intermittent spotting or bleeding. Return of menses is rare among fully breast-feeding women in the first 8 weeks postpartum.
研究一组哺乳期妇女的产后出血情况，并将其与恶露的传统定义进行比较。
对菲律宾马尼拉的477名有经验的哺乳期妇女从分娩开始进行前瞻性跟踪，并在月经日记中记录阴道出血情况。使用生存分析计算恶露的中位持续时间。此外，还记录了产后前8周内所有与恶露无关的出血情况。
恶露的中位持续时间为27天，且不受产妇年龄、产次、婴儿性别或体重、母乳喂养频率或补充水平的影响。超过四分之一的妇女经历了一次出血事件，该出血事件与最初的恶露流至少间隔4个无出血日，且开始时间不晚于产后第56天。10名哺乳期妇女可能在第56天之前首次月经来潮。
恶露持续的时间比传统认为的2周长得多。产后出血停止后再次开始或表现为间歇性点滴出血或出血是很常见的。在产后前8周内，纯母乳喂养的妇女月经复潮很少见。
