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AY Reproduction > Contraception & unplanned pregnancy > Flashcards

Contraception & unplanned pregnancy Flashcards

1
Q

How long does the COC take to work?

A

7 days

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2
Q

How does the COC work?

A

decreases LH & FSH release (HPO axis)

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3
Q

What are the advantages of the COC?

A

Regular, lighter,less painful periods
Decreased risk of endometrial,ovarian & rectal cancers
When stopped normal fertility

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4
Q

Which groups is the COC not suitable for?

A 
Very overweight 
Age >35 + smoker 
Migraine with aura
Past history of VTE 
Past history of breast or cervical cancer 
Cervical ectropion
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5
Q

How long does the progesterone-only pill take to work?

A

2 days

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6
Q

How does the progesterone-only pill take to work?

A

Thickens cervical mucous

Can suppress ovulation

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7
Q

What are the advantages of the progesterone-only pill?

A

Can be used if >35 + smoker

Can be used in breastfeeding

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8
Q

What are the disadvantages of the progesterone-only pill?

A

May cause ovarian (follicular) cysts
May cause migraine, breast tenderness
May cause weight gain & headaches

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9
Q

How does the implant work?

A

Inhibits ovulation

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10
Q

What are the side effects of the implant?

A

Irregular periods
Weight gain
Acne
Nerve damage/vascular injury

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11
Q

How does the deep injection (deprovera/savana press) work?

A

Inhibits ovulation

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12
Q

What are the advantages of the deep injection?

A

Lasts for 13 weeks

Can be used if breast feeding

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13
Q

What are the disadvantages of the deep injection?

A

Periods may stop, become irregular or last longer
Fertility may not return for 12 months
Weight gain

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14
Q

What is the main mechanism of action of an IUS (Mirena/Jaydress)?

A

Thins endometrium to preventimplantation

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15
Q

What are the advantages of an IUS?

A

Mirena = 5 yrs Jaydress = 3 years
Mirena - lighter less painful periods
When removed fertility returns to normal

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16
Q

What are the disadvanages of an IUS?

A 
Irregular bleeding & spotting for 6 months Ammenorrhoea in 30%
PID risk (first 30 days) 
Ovarian cysts
17
Q

How does the copper IUD work?

A

Inflammatory endometrial response preventing implantation

Toxic to sperm

18
Q

How long can a copper IUD last?

A

5-10 years

19
Q

What is a contraindication for the copper IUD?

A

Endometrial cancer

If high STI risk

20
Q

What is the legal limit for social termination of pregnancy?

A

23 weeks & 6 days

21
Q

In Tayside, what is the limit for surgical terminations of pregnancy?

A

Up to 12 weeks

22
Q

In Tayside, what is the limit for medical termination of pregnancy?

A

Up to 18 weeks & 6 dyas

23
Q

How is a medical TOP performed?

A

Oral mifepristone 200mg (anti-progesterone)

24-48 hours later - vaginal (or oral) prostaglandin (e.g. misoprostol)
if < 9 weeks can be done at home

24
Q

How is a pregnancy terminated surgically if it is 6-12 weeks?

A 
Cervical priming (vaginal prostaglandin)
Vacuum aspiration
25
Q

How is a pregnancy terminated surgically if it is 13-24 weeks?

A

Dilation & evacuation(not avails in Scotland)

26
Q

How is a termination of pregnancy followed up?

A

Urine pregnancy test at 2-3 weeks

27
Q

When can you take the levonelle after UPSI?

A

Up to 72 hours

28
Q

When can you take ellaOne post UPSI?

A

Up to 120 hours

29
Q

What can levonelle not be given with?

A

Enzyme-inducers

30
Q

What can ellaOne not be given with?

A

Antacids

31
Q

How long after UPSI can a copper IUD be inserted?

A

Up to 120 hours

32
Q

When should a pregnancy test be performed after emergency contraception?

A

3 weeks for all methods

33
Q

In terms of women who havehad their last period when should contraception be stopped?

A

Postmenopausal = not had a period for 12 months

If <50 y/o still require contraception or to not have had a period for 2 years

34
Q

Which form of contraception is absolutely contra-indicated in pregnancy?

A

Combined oral contraceptive pil

AY Reproduction (23 decks)

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