North American Registry of Midwives (NARM) Practice Exam

What is the primary content of lochia serosa?

1. Blood and decidual tissue

2. Serous fluid and leukocytes

3. Pus and bacteria

4. Amniotic fluid

The correct answer is: Serous fluid and leukocytes

Lochia serosa is a type of postpartum uterine discharge that typically occurs from about four to ten days following childbirth. The primary content of lochia serosa includes serous fluid, which is a clear to pinkish fluid, and leukocytes, which are white blood cells that help to prevent infection as the body recovers from delivery. This composition indicates that the body is healing and that the initial heavy bleeding, which includes blood and decidual tissue (found in lochia rubra), is tapering off and changing in consistency and color. The presence of serous fluid suggests that the discharge is less about shedding blood or damaged tissue, which characterizes earlier phases. The leukocytes in lochia serosa play a crucial role in maintaining the health of the woman as they respond to potential infections during the postpartum period. The shift to lochia serosa is an essential part of the healing process, representing the transition towards the final phase of lochia, known as lochia alba, which is even lighter and primarily consists of mucus and leukocytes. Understanding this progression is significant for midwives in monitoring the recovery of postpartum individuals and identifying any complications that may arise.