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Suspected Ectopic Pregnancy — UKMLA MCQ

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HardObstetrics & GynaecologySuspected Ectopic PregnancyUKMLAMRCEM SBAPARA

A patient ten days after miscarriage management has fever, offensive vaginal discharge, uterine tenderness and tachycardia. Ultrasound suggests retained tissue. What is the management priority?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Start sepsis care and arrange uterine evacuation

The best answer is “Start sepsis care and arrange uterine evacuation”. The presentation suggests septic miscarriage with retained infected tissue. Sepsis resuscitation, cultures when they do not delay care, broad-spectrum IV antibiotics and urgent gynaecological assessment for uterine evacuation are required. Outpatient or expectant management risks worsening sepsis, while methotrexate does not treat infected retained products.

Reference: NICE: Ectopic pregnancy and miscarriage—diagnosis and initial management (NG126): https://www.nice.org.uk/guidance/ng126