Pelvic inflammatory disease in pregnancy

For treatment of non-pregnant patients see here.

  • PID in pregnancy is rare; review diagnosis to ensure correct.
  • In all cases, obtain a sexual history.
  • Discuss all cases with genitourinary medicine consultant.

Required Investigations

  • Blood cultures (10mls in each bottle)
  • Vaginal swab for combined Chlamydia/Gonorrhoea NAAT
  • High vaginal swab

1st and 2nd Trimester

Recommended  Antibiotic

Ceftriaxone 2g IV once daily

AND

Erythromycin 500mg every 6 hours orally for 14 days

AND IF SEVERE

Metronidazole 400mg every 8 hours orally for 14 days

In penicillin anaphylaxis or cephalosporin allergy seek advice from obstetrics and GUM  

 

3rd Trimester

Seek advice from obstetrics and Chalmers Centre

Notes

Likely organisms:C. trachomatis,N. gonorrhoeae,M. genitalium,anaerobes