Missed Contraception

Question 1

Missed COCP.

<24hours

Answer 1

Whatever the week

Take active pill ASAP, and continue

Question 2

Missed COCP.
>24 hours or more than 1 pills
During week 1

Answer 2

During week 1 , even 1 pill > 24 hours significant for INDEX cycle
Take 1 active pill ASAP, continue
But back contraception 7 days,
Consider EC if UPSI within last 5 days..

Question 3

Missed COCP.
3 pills
During week 2/3

Answer 3

During week 2/3, 3 pills missed significant for INDEX cycle
But NEXT cycle also in question
Take 1 active pill ASAP, continue till end of cycle, discard placebo, start next cycle.
But back up contraception 7 days,
consider EC if repeated or prolonged omission.

Question 4

Missed COCP.
>24 hours or 2 pills but not 3
During week 2/3

Answer 4

During week 2/3, 1 pill ( >24 hours) or 2 pills missed no effect on INDEX cycle so no back up contraception or EC
But NEXT cycle in question
Take 1 active pill ASAP, continue till end of cycle, discard placebo, start next cycle.

Question 5

Missed contraception in week 1 or 2/3 what the difference

Answer 5

Week 1 noncompliance > 24 hours, put INDEX cycle in question
Week 2/3 noncompliance > 72 hours, put INDEX cycle in question
Week 2/3 noncompliance > 24 hours, next cycle in question.

Question 6

Detachment of contraceptive patch

< 24hours

Answer 6

Whatever the week
Reapply or replace with new PATCH ASAP, and continue.
Patch change day will remain the same.

Question 7

Detachment of contraceptive patch or delayed application
= or > 24hours or unsure how long.
Week 1

Answer 7

Apply NEW PATCH ASAP and start a new patch cycle
This will now be “ DAY 1 “ of your new cycle.
But back up contraception 7 days,
Consider EC if UPSI within last 5 days.

Question 8

Detachment of contraceptive patch or delayed application
< 72 hours
Week 2/3

Answer 8

Apply NEW PATCH ASAP and start a new patch cycle
This will now be “ DAY 1 “ of your new cycle.
Complete cycle.
Then Start new cycle without HFI.
No need of back up contraception or EC.

Question 9

Detachment of contraceptive patch or delayed application
> 72 hours
Week 2/3

Answer 9

Apply NEW PATCH ASAP and start a new patch cycle
This will now be “ DAY 1 “ of your new cycle.
Complete cycle.
Then Start new cycle without HFI.
But need of back up contraception for 7 days.
Consider EC if repeated or prolonged omission.

Question 10

Removal of contraceptive ring

< 3 hours

Answer 10

Whatever the week
Insert the ASAP.
Keep it in until the scheduled ring removal day.

Question 11

Removal of contraceptive ring > 3 hours or unsure when?
or delayed insertion equal or more than 24 hours
week 1

Answer 11

Insert the ASAP.
Keep it in until the scheduled ring removal day.
But need of back up contraception for 7 days.
Consider EC if UPSI within last 5 days..

Question 12

Removal of contraceptive ring > 3 hours but less 72 hours
or delayed insertion equal or more than 24 hours
week 2/3

Answer 12

Insert the ASAP.
Keep it in until the scheduled ring removal day.
Start NEW CYCLE with NEW RING with no HFI.
No need of back up contraception for 7 days or EC

Question 13

Removal of contraceptive ring > 72 hours
or delayed insertion equal or more than 24 hours
week 2/3

Answer 13

Insert the ASAP.
Keep it in until the scheduled ring removal day.
Start NEW CYCLE with NEW RING with no HFI.
But need of back up contraception for 7 days.
Consider EC if repeated or prolonged omission.

Question 14

POP pill delayed >3 hours or missing 1 or more pill

UPSI last 5 days

Answer 14

EC
Take 1 pill NEXT DAY & continue 1 pill daily same hour.
Back up contraception for 48 hours.

Question 15

POP pill delayed >3 hours or missing 1 or more pill

No UPSI last 5 days

Answer 15

Take 1 pill ASAP & continue 1 pill daily same hour.

Back up contraception for 48 hours.

Question 16

Last contraception injection 13 to<14 weeks

Answer 16

Give next injection ASAP

Question 17

Last contraception injection 14 weeks or more

No UPSI in last 14 days

Answer 17

If b-HCG is negative.
Give next injection ASAP
Back-up contraception for 7 days

Question 18

Last contraception injection 14 weeks or more

UPSI in last 5 days

Answer 18

If b-HCG is negative.
Give EC & next injection ASAP
Back-up contraception for 7 days.
Repeat b-HCG (urinary preferred) 3 weeks later.

Question 19

Last contraception injection 14 weeks or more

UPSI in > 5 days ago but Less than 14 days.

Answer 19

If b-HCG is negative.
Give next injection ASAP
Back-up contraception for 7 days.
Repeat b-HCG (urinary preferred) 3 weeks later.

Question 20

contraceptive patch is effective for how many days

Answer 20

9 days

Question 21

If patch 1 and 2 left on

9 - < 12 days

Answer 21

Apply NEW PATCH, this will now be “ patch change day” of your remaining cycle.
Complete cycle.
Then Start new cycle without HFI.

Question 22

If patch 1 and 2 left on

12 days or more

Answer 22

Apply NEW PATCH, this will now be “ patch change day” of your remaining cycle.
Complete cycle.
Then Start new cycle without HFI.
But need of back up contraception for 7 days.
Consider EC if UPSI within last 5 days..

Question 23

contraceptive ring is effective for how many days

Answer 23

28 days, use upto 35 days should not reduce efficacy, as it will only add 7 days HFI.

Question 24

Contraceptive ring left in for 28-35 days

Answer 24

Inset a new ring without HFI

Keep it until the scheduled ring removal day

Question 25

Contraceptive ring left in for >35 days

Answer 25

Inset a new ring without HFI
Keep it until the scheduled ring removal day.
Consider EC if UPSI within last 5 days..