MSFinals-3302

MSFinals-3302

A 29-year-old woman presents with a positive pregnancy test and brown vaginal discharge. Four weeks ago, she was diagnosed with an incomplete miscarriage at eight weeks’ gestation, which was medically managed with misoprostol. She reports passing big clots the day after and lightly bleeding since. An ultrasound scan reports a ‘heterogeneous appearance of the endometrial cavity suspicious of retained products of conception’. Her heart rate is 100 bpm, blood pressure 100/80 mmHg and temperature 38.0 °C. Abdominal examination reveals a tender abdomen, with cervical excitation on vaginal examination.
What is the most appropriate next step in managing this patient?