A 28-year-old woman, 6 weeks postpartum after an emergency caesarean section, presents to the GP with persistent lower abdominal pain, low-grade fever...

Question

A 28-year-old woman, 6 weeks postpartum after an emergency caesarean section, presents to the GP with persistent lower abdominal pain, low-grade fever (37.8°C), and offensive vaginal discharge. A pelvic ultrasound shows a thickened endometrium with echogenic material consistent with retained products of conception. Which is the single most appropriate management?

Accepted Answer

Refer for same-day obstetric assessment with a view to surgical evacuation and intravenous antibiotics

Answer

Prescribe oral antibiotics and arrange outpatient follow-up in 1 week

Answer

Prescribe oral misoprostol to expel the retained products

Answer

Reassure that retained products are common after caesarean section and will resolve

Answer

Arrange a repeat ultrasound in 4 weeks

uk-drcog MCQ (SBA): Infected Retained Products of Conception