Which of the following would indicate an abnormal finding during the postpartum period?
a. Lochia flow changing from alba to rubra
b. Unable to palpate uterine fundus at 6-week postpartum checkup
c. Presence of afterbirth pains
d. Lochia flow heavier in the early morning 2 days following vaginal birth
ANS: A
Lochia flow should progress from rubra to serosa to alba as part of the normal sequence. A change in sequence would indicate an abnormal finding and possible infection and/or bleeding. The uterine fundus should no longer be palpable at 2 weeks postbirth. Afterbirth pains during the postpartum period are a normal finding based on involution of the uterus. Lochia flow may be heavier on arising because of the effects of gravity and pooling of blood while recumbent.
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