IUD and Infection

Question 1

Choose the false answer(s).

a) Counselling for IUD should include the fact that the risk of PID is increased for the first 20 days post insertion
b) All women receiving an IUD should be screened for BV
c) Swabs for STIs should be done before or at the time of IUD insertion if the patient has risk factors based on hx
d) If treating mild to moderate PID, you should not remove the IUD unless infection persists for 72 hours

Answer 1

b

Question 2

Choose the false answer(s).

a) In severe PID the IUD should be removed after starting Abx therapy.
b) The risk of PID is the same whether or not women were screened for STIs prior to insertion
c) Co-existent BV increases the risk of a patient with an active STI developing PID after IUD insertion.
d) Current evidence supports treating high risk women with prophylactic Abs at the time of insertion

Answer 2

c

Question 3

What are the risk factors identified in the guideline for STI?

Answer 3

1. Young age <26
2. new partner
3. 1+ partner in the last year
4. hx of previous STI

Question 4

How should you manage a patient with PID and an IUD in situ?

Answer 4

Mild to moderate PID - remove IUD only at patient’s request or if not improving clinically after 72hrs Abx
(may have improved short term outcomes if removed but no difference in long term outcomes -consider unintended pregnancy)
Severe PID - remove as soon as Abx started