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Urinary retention postpartum — DRCOG MCQ

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HardPostnatalUrinary retention postpartumDRCOG

A 37-year-old woman six hours after instrumental delivery has suprapubic pain and cannot pass urine. What is the most likely diagnosis?

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Correct answer: D — Catheterise and assess post-void residual pathway

Catheterise and assess post-void residual pathway is the best answer because the vignette is testing Urinary retention postpartum and the recommended approach is consistent with NICE NG194. The other diagnoses do not explain the combination of timing, examination findings and investigation results as well as the correct diagnosis. Specifically, Endometrial cancer; Placental abruption; Genital herpes; Stress urinary incontinence would be suboptimal in this scenario. The key discriminator is the pattern across symptoms, examination and timing, not a single isolated symptom.

Reference: NICE NG194