Step 2

Obstetrics 5

A 32-year-old woman, gravida 2, para 2 who is 5 days postpartum is evaluated for persistent spiking fevers. She also reports a diffuse, constant, non-colicky pain in her pelvis and groin that began earlier in the day. The pregnancy and vaginal delivery were uneventful, and she developed fever 2 days after delivery and shortly before she was going to be discharged. Endometritis was suspected. Cultures of the endometrium, vagina, blood, and urine were obtained, and she was started empirically on intravenous clindamycin and gentamicin. The fevers persisted, and the cultures all came back negative. A CT scan of the abdomen and pelvis is performed and rules out pelvic abscess.

Which of the following is the most appropriate next step in management?

  • A) Change to broader spectrum intravenous antibiotics
  • B) Discharge home with pain management and oral antibiotics
  • C) Perform exploratory laparotomy
  • D) Start anticoagulation therapy with heparin and continue intravenous antibiotics
  • E) Repeat CT scan in 48 hours

Authors

Lloyd Taylor

Editor

Dr. Ted O'Connell

Last updated

Jun 09, 2024

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