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Gynaecology & Obstetrics recent papers obst b79f3c8d

A 22 year old pregnant lady presents with fever, and is put on antibiotics. Fever is still not brought under control, On fuher investigation she is diagnosed to have septic pelvic thrombophlebitis. Which among the following is the next coursee of treatment for her?

A
Stop antibiotics and sta heparin
B
Antibiotics+Heparin
C
Surgical embolectomy
D
Hysterectomy
High-Yield Explanation
Antibiotics plus heparin is the next course of treatment amongst the given options. The treatment of septic pelvic thrombophelbitis is broad-spectrum antibiotics plus anticoagulation. Anticoagulation is thought to prevent fuher thrombosis and reduce the spread of septic emboli. The use of anticoagulation is contraversial as not all clinicians or it. A small randomized study didnot demonstrate a benefit, however, the study was powered to assess fever resolution only; it did not address the potential benefit of anticoagulation with regard to the risk of thrombus extension, pulmonary embolus or associated thrombophilias. Ref: Online resources

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