Family planning and Sexual health

Question 1

What advice can you give after giving the emergency contraceptive pill (levonorgestrel)?

Answer 1

• nausea is a common s/e - can be given domperidone
• if she vomits, come back for a 2nd dose asap
• a barrier method of contraception needs to be used until next period
• the next period may be early or late - if very late or unusual take a pregnancy test (should probs take one anyway in a couple of weeks)
• return promptly if severe lower abdominal pain occurs to rule out ectopic

Question 2

What should you always do before giving emergency contraception

Answer 2

Pregnancy test

Question 3

What are the complications associated with bacterial vaginosis and pregnancy?

Treatment for BV in pregnancy?

Answer 3

• late miscarriage
• preterm birth
• PPROM
• postpartum endometritis

Metronidazole for 5-7 days

Question 4

What are the swabs for an STI screen and what do they screen for?

Answer 4

• high vaginal: BV, trichomonas, candida
• endocervical: gonorrhoea
• endocervical: chlamydia (30 secs and rotate brush)