A 24-year-old woman at 14 weeks of gestation is diagnosed with mild pelvic inflammatory disease based on cervical motion tenderness and mucopurulent discharge. Which statement regarding her management is correct?
- A She requires hospitalization and treatment with a parenteral cephalosporin combined with azithromycin ✓
- B She can be managed as an outpatient with oral doxycycline and metronidazole
- C She should receive ceftriaxone followed by oral levofloxacin
- D Antibiotic therapy should be deferred until after delivery unless fever develops
Correct answer: A. She requires hospitalization and treatment with a parenteral cephalosporin combined with azithromycin
Explanation
PID in pregnancy is an indication for hospitalization and parenteral therapy. Tetracyclines including doxycycline are contraindicated in pregnancy because of effects on fetal teeth and bone, which eliminates option B. Fluoroquinolones are also avoided in pregnancy. The accepted approach is a parenteral cephalosporin such as ceftriaxone together with azithromycin, which covers chlamydial coinfection safely. Untreated PID in pregnancy risks miscarriage, preterm birth, and maternal morbidity.
Reference: CDC Sexually Transmitted Infections Treatment Guidelines, 2021 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.