Peer Reviewed
Feature Article Obstetrics and gynaecology
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Pelvic inflammatory disease: management of new-onset low abdominal pain in young women

Deborah Bateson, Natalie Edmiston

Pelvic inflammatory disease (PID) is a highly variable syndrome that should be considered in all young women presenting with new-onset low abdominal pain. Prompt antibiotic treatment is essential to prevent potentially serious complications. Tests are often negative for sexually transmitted infection but rapid clinical improvement with treatment supports the diagnosis of PID.

Key Points
  • Pelvic inflammatory disease (PID) is an upper genital tract inflammatory syndrome with highly variable symptoms.
  • The diagnosis of PID should be considered in all young women who present with new-onset low abdominal pain.
  • A urine pregnancy test is essential in all women of childbearing age with new-onset low abdominal pain to exclude ectopic pregnancy.
  • Prompt treatment of women with suspected PID with ceftriaxone, azithromycin, doxycycline and metronidazole to cover the potential polymicrobial causes is essential to prevent long-term complications.
  • Transfer to the nearest emergency department is warranted for women with severe symptoms or haemodynamic instability.
  • Sexual contacts should be tested and treated to prevent recurrence of PID.

    Picture credit: © Kevin A. Somerville

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