What would likely be observed in a physical exam of a patient with postpartum endometritis?

In a patient with postpartum endometritis, the most notable finding during a physical examination is uterine tenderness. Postpartum endometritis is an infection of the endometrium, which is the lining of the uterus, and it typically occurs after childbirth. This infection can result in inflammation and pain, leading to increased sensitivity in the uterine region on palpation.

The presence of uterine tenderness during the examination signifies inflammation and potential infection. The clinician may also observe other symptoms such as fever, a foul-smelling vaginal discharge, and possibly an elevated heart rate, which are common signs associated with infections. However, the key physical finding highlighting the diagnosis is the tenderness of the uterus itself upon examination.

Other options reflect conditions or observations that are not typically associated with postpartum endometritis. For instance, normal uterine size would contradict the expected signs of infection, as endometritis typically leads to an enlarged or at least tender uterus. Free fluid in the abdomen may be indicative of other issues, such as ascites or hemorrhage, rather than endometritis specifically. Lastly, a high fetal heart rate is not applicable in the context of examining a postpartum patient, as it pertains to fetal circulation and is not a relevant finding for diagnosing maternal conditions.