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Septic abortion — RCPSC EM MCQ

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HardOB/GYN emergenciesSeptic abortionRCPSC EM

A 19-year-old has fever, foul discharge and uterine tenderness one week after pregnancy termination. BP is 90/52 mmHg and lactate 4.1 mmol/L. What is the immediate management plan?

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Correct answer: E — Give IV antibiotics, resuscitate and seek urgent source control

The best answer is “Give IV antibiotics, resuscitate and seek urgent source control”. Septic abortion or miscarriage with shock requires sepsis resuscitation, broad-spectrum IV antibiotics, admission and urgent gynaecology involvement to treat retained tissue or another source. Cultures are useful when obtainable promptly but must not delay antibiotics or source control.

Reference: Emergency Care BC: Miscarriage—Treatment: https://emergencycarebc.ca/clinical_resource/clinical-summary/1st-trimester-bleeding-miscarriage-treatment/