Sheila C., 21

Sheila is the first-born in a family of four children and currently lives with her grandmother, who is her main caregiver. She dropped out of school in Form Two because the family could not afford school fees. The household depends entirely on small-scale farming, with limited income for food, healthcare and other basic needs. Sheila was referred from Korosiandet Health Centre with suspected retained products of conception following a miscarriage. She had experienced persistent vaginal bleeding for 18 days, associated with lower abdominal pain and recurrent fever. Over time, she became increasingly weak, pale and exhausted, with poor appetite and reduced ability to perform normal activities. One day before referral, the bleeding became significantly heavier and was accompanied by dizziness, profound weakness and fatigue, raising concern for substantial blood loss and infection. Given her deteriorating condition, she required urgent referral for specialized assessment, stabilization and definitive management.

Sheila presented with prolonged vaginal bleeding and suspected sepsis secondary to retained products of conception, a potentially life-threatening condition. Continued retention may cause severe infection, haemorrhage, worsening anaemia, septic shock and organ dysfunction. Urgent antibiotics, stabilization, management of blood loss and evacuation of retained tissue where indicated are essential. With timely definitive treatment and close monitoring, her prognosis is favourable, although delayed treatment increases the risk of serious complications.