Patient's question:
Doctor, hello! I gave birth to my daughter on December 4, 2004, via a normal delivery, but the was occiput posterior. Forceps were used, and there was significant bleeding. Since then, the lochia has not stopped, and it has always been blood-like lochia, with a bright red color, sometimes pink, and the amount fluctuates, with a cycle of about ten days. It starts with a lot and gradually decreases, more during the day and less at night. When it's almost done, it suddenly increases again. It has been two and a half months now, and it's still the same. I went to the hospital for a check-up, had a black and white ultrasound, and found a 11.41 cm echo mass in the right ovary. HCG was also tested, and the results wereDoctor's answer:
Traditional Chinese Medicine (TCM) holds that lochia is derived from blood transformation. Postpartum deficiency of qi and blood or blood stasis retention can both lead to continuous lochia. If a woman has a constitutionally weak body, insufficient qi and yin, blood loss during labor depletes qi, further weakening the healthy qi. Alternatively, excessive labor shortly after delivery may strain the spleen, causing qi deficiency and sinking, which fails to arrest blood. Or, exposure to heat postpartum or liver qi stagnation transforming into heat may disturb the (Chong Ren) channels, forcing blood downward, resulting in unending lochia. When blood stasis lingers within the uterus or uterine vessels are empty, cold pathogens may invade the uterus, struggle with blood, and cause internal stasis, preventing blood from returning to its proper channels, leading to prolonged, intermittent lochia. Therefore, the treatment of this condition should focus on replenishing deficiency and removing stasis. Replenishing deficiency primarily involves nourishing qi and blood, while removing stasis should be combined with qi-regulating herbs to embody the principle that "qi flows, blood flows." For women with unending lochia due to postpartum endometritis or other reproductive system infections, clearing heat and detoxifying methods should also be employed, without rigidly adhering to the notion that "postpartum conditions should be treated with warmth." Additionally, astringent and hemostatic methods should not be overlooked and can be combined with blood-activating and stasis-removing techniques, achieving balance between promoting circulation and maintaining stability, working synergistically. After lochia ceases, qi-nourishing and yin-tonifying herbs should be prescribed according to symptoms to finalize the recovery.