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Puerperal sepsis — DRCOG MCQ

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HardPostnatal CarePuerperal sepsisDRCOG

A 26-year-old woman is 5 days postpartum and feels flu-like with abdominal pain. Temperature is 39.1°C, pulse 126 bpm and blood pressure 92/58 mmHg. She has offensive lochia after a prolonged labour. What is the most appropriate management?

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Correct answer: E — Arrange emergency hospital admission for sepsis management

Fever, tachycardia, hypotension and offensive lochia suggest puerperal sepsis with haemodynamic compromise, requiring emergency admission. Oral antibiotics and delayed review are unsafe in possible sepsis. Swabs may be taken but should not delay treatment. The pearl is that postpartum sepsis can deteriorate rapidly and may present initially as flu-like illness.

Reference: NICE NG51; RCOG sepsis guidance