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Septic miscarriage — DRCOG MCQ

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HardEarly PregnancySeptic miscarriageDRCOG

A 22-year-old woman at 11 weeks' gestation presents with heavy bleeding, fever, offensive discharge and lower abdominal tenderness. Her pulse is 128 bpm and she looks unwell. What is the most appropriate management?

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Correct answer: D — Arrange emergency hospital admission for suspected septic miscarriage

Fever, offensive discharge, uterine tenderness and tachycardia suggest septic miscarriage, which requires emergency hospital care, broad-spectrum antibiotics and gynaecological assessment. Routine review is unsafe with sepsis features. Oral iron does not treat infection or haemodynamic risk. Expectant management is inappropriate when infection is suspected.

Reference: NICE NG126; NICE NG51