A patient presents for routine postpaum examination 2 weeks after a normal vaginal delivery with complains of foul smelling vaginal discharge with fever. On abdominal examination, a tender 14 weeks uterus is palpable, breast examination is normal and episiotomy is healthy. What could be the possible diagnosis?
This is a case of subinvolution of uterus secondary to infection which has resulted in fever and foul smelling lochia SUBINVOLUTION OF UTERUS Normal rate of reduction of size of uterus post delivery: 1-2 cm/ day Uterus becomes pelvic organ by 2 weeks and returns to normal size by 6 weeks Causes: Retained bits of placenta Infection Blood clots Fibroids Clinical features boggy or flabby uterus palpable after 2 weeks per abdomen tender Treatment Uterine evacuation Iv antibiotics Methyl ergometrine
Choriocarcinoma
Adenomyosis
Fibroid uterus
Subinvolution of the uterus
Puerperium