Contraception - Emergency Flashcards Preview

B - Gynaecology > Contraception - Emergency > Flashcards

Flashcards in Contraception - Emergency Deck (36)
1

What is the purpose of emergency contraception?

Prevent pregnancy following sexual intercourse

2

How does emergency contraception differ from other forms of contraception?

It is used after sex, whereas other forms are used before or during sex

3

What are the indications for emergency contraception?

- Sexual intercourse without contraception
- Contraceptive method has failed

4

Give an example of how a contraceptive might fail

Condom torn

5

When might women using POP or COCP need emergency contraception?

If they miss pills, depending on how many pills have been missed

6

What are the types of emergency contraception?

- Emergency hormonal contraception (morning after pill)
- Intrauterine device

7

What are the types of morning after pill available in the UK?

- Levonorgestrel
- Ulipristal acetate

8

What is the brand name for Ulipristal acetate?

EllaOne

9

What is levonorgestrel?

Synthetic progesterone

10

How does levonorgestrel work?

It delays ovulation by 5-7 days, after which any sperm will be non-viable

11

What is ulipristal acetate?

A progesterone receptor modulator

12

How does ulipristal acetate work?

It delays ovulation for 5-7 days, after which any sperm will be non-viable

13

How long after unprotected sex can levonorgestrel be used?

Within 72 hours of unprotected sex

14

How long after unprotected sex can ulipristal acetate be used?

Within 120 hours of unprotected sex

15

Do hormonal emergency contraceptives have an effect on implantation?

No

16

What is the copper intrauterine device usually used as?

A method of long-term non-hormonal contraception

17

How long after unprotected sex can the copper coil be inserted to be used as emergency contraception?

Within 5 days

18

How does the copper coil work as emergency contraception?

Toxic to sperm, and may induce a sterile inflammatory response within the uterus that makes implantation impossible

19

How long does the copper coil provide contraception for if used as emergency contraception?

5-10 years (depending on type) as long as it remains in situ

20

How effective is the copper coil as emergency contraception?

99% effective

21

Who should the copper coil be offered to as emergency contraception?

All women presenting

22

What are the absolute contraindications to levonorgestrel as emergency contraception?

None

23

What reduces the efficacy of levonorgestrel as emergency contraception?

- Diseases of malabsorption
- Enzyme inducing drugs

24

Give an example of a disease of malabsorption

Crohn's

25

Give an example of an enzyme inducing drug

Rifampicin

26

What should be done if a patient requiring emergency contraception who is on an enzyme inducing drug refuses the IUD?

Double dose of levonorgestrel, e.g. 3mg at once, may be taken.

Ulipristal acetate is absolutely contraindicated here

27

What are the contraindications to ulipristal acetate?

- Diseases of malabsorption
- Hypersensitivity to ulipristal acetate
- Severe hepatic dysfunction
- Enzyme inducing drugs
- Breast feeding
- Asthma insufficiently controlled by corticosteroids
- Drugs decreasing gastric pH

28

How long after taking ulipristal acetate should breastfeeding be avoided?

7 days

29

Give 2 examples of drugs reducing gastric pH

- Omeprazole
- Ranitidine

30

What are the contraindications to the copper IUD as emergency contraception?

- Uterine fibroids with distortion of uterine cavity
- Documented or suspected pelvic inflammatory disease
- Documented or suspected STI, especially chlamydia or gonorrhoea

31

What are the adverse effects of emergency hormonal contraception?

- Nausea
- Dizziness
- Menstrual disturbance
- Abdominal pain

32

What are the adverse effects of IUD?

- Pelvic infections
- Expulsion of IUD
- Bleeding
- Pelvic pain

33

In what forms should follow up advice be provided for emergency hormonal contraception?

- Verbal
- Written

34

What follow up advice should be given in a patient taking emergency hormonal contraception?

- Seek help if vomiting occurs within 2 hours of taking levonorgestrel, or 3 hours of taking ulipristal, as the medication may not have been absorbed adequately
- Effectiveness of hormonal methods decreases as the time since sexual intercourse increases

35

What follow up advice should be given in a patient using copper coil is emergency contraception?

Increased relative risk of ectopic pregnancy following insertion of IUD

36

What should the patient be alert to as signs fo ectopic pregnancy following IUD insertion for emergency contraception?

Next period is >5 days late with reduced bleeding, especially coupled with severe lower abdominal pain