How do you manage a 28-year-old woman, P1L1 with unilateral Tubo-ovarian abscess?

Managing a 28-year-old woman, P1L1, with a unilateral Tubo-ovarian abscess involves several key steps:

Initial Assessment:

- Conduct a thorough clinical evaluation, including history and physical examination.

- Confirm diagnosis with imaging, such as ultrasound or CT scan.

Medical Management:

- Initiate broad-spectrum intravenous antibiotics targeting common pathogens like E. coli and Bacteroides (Hagerty et al., 2018).

- Consider antibiotics such as ceftriaxone, doxycycline, and metronidazole.

Surgical Intervention:

- If no improvement within 48-72 hours, consider surgical options.

- Options include laparoscopic drainage or salpingo-oophorectomy, depending on severity and fertility desires.

Fertility Considerations:

- Discuss future fertility plans; preserve ovarian tissue if possible.

- Consider referral to a fertility specialist if needed.

Follow-up Care:

- Schedule follow-up appointments to monitor recovery.

- Educate on signs of recurrence and preventive measures.

Psychosocial Support:

- Provide emotional support and counseling, addressing concerns about fertility and health.

This comprehensive approach ensures effective management and addresses both medical and psychosocial aspects.