Differential Diagnosis for Postpartum Vaginal Discharge
Single Most Likely Diagnosis
- Endometritis: This is a common cause of postpartum discharge, especially if it's darkish in color. Endometritis is an infection of the uterus that can occur after childbirth, and it often presents with abnormal vaginal discharge, fever, and uterine tenderness. The darkish discharge could be indicative of the infection.
Other Likely Diagnoses
- Retained Products of Conception (RPOC): RPOC can cause abnormal vaginal discharge, which may be dark or foul-smelling. This condition occurs when parts of the placenta or fetus are not expelled during delivery.
- Vaginal Infection: Bacterial vaginosis or other vaginal infections can cause abnormal discharge. These infections are common in the postpartum period due to hormonal changes and the disruption of the normal vaginal flora.
- Cervical or Uterine Polyps: These growths can cause abnormal vaginal bleeding or discharge, which may be dark in color.
Do Not Miss Diagnoses
- Malignancy: Although rare, it's crucial not to miss a potential malignancy, such as cervical or endometrial cancer, which can present with abnormal vaginal discharge.
- Pelvic Abscess: A collection of pus in the pelvic region can cause severe symptoms, including abnormal discharge, fever, and pelvic pain. This condition requires prompt medical attention.
- Septic Pelvic Thrombophlebitis: This is a rare but potentially life-threatening condition where a blood clot in the pelvic veins becomes infected. It can present with fever, pelvic pain, and abnormal discharge.
Rare Diagnoses
- Asherman's Syndrome: This condition involves the formation of adhesions or scar tissue in the uterus, which can cause abnormal menstrual bleeding or discharge. It's a rare complication of uterine surgery, including dilation and curettage (D&C).
- Foreign Body: A retained foreign body, such as a piece of gauze or a contraceptive device, can cause abnormal discharge. This is a rare occurrence but should be considered in the differential diagnosis.