A 26-year-old woman presents to the Emergency Department of the local hospital because she is feeling unwellI. Her last menstrual period occurred eigh

Subject
Obstetrics and Gynaecology
System
Female Reproductive System & Breasts

Kathryn

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Jul 29, 2020
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A 26-year-old woman presents to the Emergency Department of the local hospital because she is feeling unwellI. Her last menstrual period occurred eight weeks ago - she usually has periods every month and she bled heavily vaginally yesterday. The bleeding has been less today. She looks unwell, her pulse rate is 130/min, BP 110/60mmHg, and her temperature is 39.5°C. On abdominal examination she has suprapubic tenderness and guarding, but no evidence of a pelvic mass. Speculum examination shows the cervix is open with apparent products of conception in the upper vagina. Which one of the following is the most appropriate next step in managment?
(A) Curettage
(B) Administration of ergometrine
(C) Curettage after twelve hours of antibiotic therapy
(D) Cervical swabs for microscopic assessment and culture
(E) Antibiotic administration
 
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