Emergency Contrapcetion FSRH Flashcards
When is emergency contraception needed for
- patch/ring
Removal > 48 hours
When is emergency contraception needed for
COCP
2+ missed pill in week 1 after HFI
> 7days HFI is UPSI taken place in HFI
When is emergency contraception needed for liver enzyme inducing drugs?
If no additional contraceptive COCP, POP, implant whilst taking enzyme inducing drugs or 28 days after
When is emergency contraception needed for POP
Traditional >27 hrs
Desogestrel >36 hrs
Drospirenon >48hrs
When is emergency contraception needed for progesterone injection
> 14 weeks since last DMPA
UPSI within 1st 7 days after late injection
When is emergency contraception needed for Cu-IUD/LNG-IUS
Removal without immediate replacement and UPSI within 7 days before removal
How long is ulipristal acetate effect for after UPSI? How how effective is it?
120hrs
1-2% risk pregnancy
What type of drugs is ulipristal acetate? How does it work?
Selective progesterone receptor modulator, delays ovulation >5 days, still effective after LH surge started
How long after UPSI is LNG effective, how effective?
72-96 hours after SI
0.6-2.6% less effective further away from SI
How does LNG work?
Inhibits ovulation, delaying or preventing follicular rupture, most be taken before LH surge
ineffective after ovulation
Contraindications UPA
Sebere asthma controlled by glucocorticoids
What emergency contraception if enzyme inducing drugs
Cu-IUD
or 3mg LNG
When is Cu-IUD effective
Within 5 days of UPSI or 5 days of likely ovulation
Which contraception when breastfeeding?
1st line Cu-IUD but higher risk perforation
After UPA - express and discard for 1 week
LNG fine
Multiple doses within
same cycle with oral emergency contraception?
Yes but wait 5 day
Decision making flow diagram Cu-IUD vs hormonal EC
Decision making flow diagram if CU-IUD not acceptable, UPA vs LNG
