IUD-associated PID — DFSRH MCQ

Instant feedback + full explanation. One question, done properly.

HardIntrauterine methodsIUD-associated PIDDFSRH

A 24-year-old develops fever, pelvic pain and a 6 cm tubo-ovarian abscess ten days after copper-IUD insertion. She is tachycardic and vomiting. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Arrange urgent admission for intravenous treatment and specialist assessment

The best answer is “Arrange urgent admission for intravenous treatment and specialist assessment”. Systemic illness, vomiting and a tubo-ovarian abscess require urgent admission for intravenous broad-spectrum treatment and gynaecological assessment, including drainage or surgery if indicated. Antibiotics must not wait for microbiology. IUD removal is not the first action before treatment, management is reviewed with clinical response and patient preference. Intrauterine-method decisions require separation of expected bleeding from pregnancy, partial expulsion, perforation and pelvic infection. Device position, pregnancy risk, recent intercourse and clinical stability determine whether treatment, removal, imaging or emergency contraception is needed. Pelvic infection is treated promptly, but an IUD is not removed routinely when the patient is improving on appropriate antibiotics.

Reference: BASHH, UK national guideline for pelvic inflammatory disease: https://www.bashh.org/resources/6/guidelines_pid_2019/ | CoSRH/FSRH, Intrauterine Contraception (March 2023, amended January 2025): https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-clinical-guideline-intrauterine-contraception-mar-23-amended.pdf