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Pelvic inflammatory disease - Management
How should I manage a woman who has an intrauterine device in situ?
- Consider removing any contraceptive intrauterine device (IUD) in women presenting with pelvic inflammatory disease (PID), after discussion with the woman.
- Experts agree that the device should be removed if the woman wishes removal or if symptoms have not resolved within 72 hours.
- Evidence is limited and expert opinion is divided over whether it is necessary to remove the IUD at the initial presentation.
- If a decision is made to remove the IUD, ask if the woman has had sexual intercourse within the last 7 days and consider offering emergency hormonal contraception. For more information see the CKS topic on Contraception - emergency.
- If the woman develops pelvic pain and has had actinomyces-like organisms (ALOs) identified on a smear in the past:
- Take endocervical swabs, and
- Urgently seek specialist advice regarding treatment.
- Consider removal of the IUD.
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