| a) If the client will not
be at high risk of an STD in the future, treat the STD today and insert the intrauterine
device (IUD) when the infection is resolved (for acute PID, wait 3 months). If she remains at increased risk of pelvic inflammatory disease
(PID), advise against IUD use. |
a) PID may take several weeks to
resolve clinically, and, in the case of severe PID, waiting several months, in theory,
allows healthy tissues (free of micro-abscesses) to form.
- Sweet RL, Draper DL, Hadley WK.
Etiology of acute salpingitis: Influence of episode number and duration of symptoms. Obstetrics
and Gynecology 1981;58:62-68.
Women with prior PID are at increased risk of repeat PID.
A woman who has had an episode of upper reproductive tract infection may be at increased
risk of repeat episodes of non-sexually transmitted PID regardless of IUD use.
Theoretically, a previous episode of upper reproductive tract infection may result in
tubal damage increasing susceptibility of the fallopian tubes to opportunistic lower
genital tract flora.
- Weström L, Mårdh P. Acute pelvic
inflammatory disease (PID), in Holmes KK, Mårdh P, Sparling PF, Wiesner PJ, Cates W,
Lemon SM, Stamm W. (eds). Sexually Transmitted Diseases, 2nd edition. New York,
McGraw-Hill Information Services Company, Health Professions Division, 1990, pp 596-613.
- Keith L, Berger GS. The etiology of
pelvic inflammatory disease. Research Frontiers in Fertility Regulation
1984;3(1):1-16.
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