After 3 days of an emergency cesarean section for Prolonged Premature ruptured membranes and Cephalopelvic dispropoion a woman presents with chills and abdomen pain and foul smelling vaginal discharge. The LSCS incision site has some serous drainage without any erythema around it. Her abdomen is tender over the fundus but no rebound tenderness is present. What is the most probable diagnosis ?
History of surgery for PROM, and pain and uterine tenderness are suggestive of endometritis. Endometritis is the most common infection that occurs following cesarean section and prolonged rupture of membranes is a risk factor for it. In case of wound infection, erythema and pus discharge around the surgical wound is usually present. In case of pelvic abscess, signs of peritoneal irritation (eg. rebound tenderness) are present. In case of Septic pelvic thrombophlebitis , usually there is no uterine tenderness.
Wound infection
Endometritis
Pelvic abscess
Septic pelvic thrombophlebitis
Puerperium