Approach to postpartum hemorrhage Quiz: Ace Your Exams
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A 31-year-old woman presents to the emergency department for evaluation of vaginal bleeding for one day. The patient has had low grade fevers for two days, has been passing a number of large clots vaginally, and has a malodorous vaginal discharge. The patient delivered a healthy baby-boy two weeks ago via cesarean section at 37-weeks gestation. This patient's pregnancy was complicated by prolonged rupture of membranes. The patient has no previous medical history. Temperature is 38°C (100.4°F), blood pressure is 112/67 mmHg, pulse is 98/min, respiratory rate is 16/min, and oxygen saturation is 99% on room air. The patient is well-appearing. Physical examination reveals a well healing Pfannenstiel incision without evidence of infection. Uterine tenderness is present on a bimanual exam and purulent vaginal discharge is seen. Urinalysis is negative. Laboratory studies are obtained and pending. Which of the following is the best next step in management?
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