Summary: A 23-year-old woman, who had undergone D&C 3 days ago for an incomplete abortion, complains of continued vaginal bleeding, lower abdominal cramping, and fever and chills. Her blood pressure is 90/40. heart rate 120 bpm, and temperature 102.5°F. The lungs are clear. There is moderately severe lower abdominal tenderness. The cervix is open, and there is uterine tenderness. Laboratory studies are significant for leukocytosis and a normal urinalysis.
♦ Most likely diagnosis: Septic abortion (with retained products of conception [POC]).
♦ Next step in management: Broad-spectrum antibiotics followed by D&C of the uterus.
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