Postpartum Care Flashcards
When is the right time to insert a CIUD and when is it not
The optimum time to insert a Cu IUD is before day 12 of the menstrual cycle or
at any other time that it can be reasonably certain the woman is not pregnant.
It is not advisable to insert later than 5 days after the earliest calculated day of
ovulation (i.e. day 19 of a 28 day cycle).
Complications of IUD (4)
Pain: cramping first few weeks
Infection: Pre-existing asymptomatic infection ascends
Bleeding: first few months more bleeding, heavy, longer and painful menses
Expulsion mainly first 6weeks or anytime during menses
Treatment for heavy bleeding while on CIUD
Always exclude pathology first
Ibuprofen 400mg 8 hourly
Tranexamic acid (Cycklokapron) 1g 8-hourly
Ponstan 500mg 3 x per day during heavy bleeding
After how long is a vasectomy effective after procedure
3months
Which EC pill is more effective between Progesterone only EC and COC EC pill
Progestin only
Grading system for contraceptive options in various medical conditions
1 The contraceptive method is safe to use in the particular condition
2 The bene its of using the contraceptive outweighs the risk of use
in The particular condition
3 The risks outweigh the bene its of use in the condition
4 Do not use the contraceptive method in that condition
MOA of Combined hormonal contraception and Progestine only
CHCs act primarily by suppressing ovulation
Progestine only thickens cervical mucus preventing sperm from fertilising and tubal mobility
Contraindication to combined hormonal contraception
Breastfeeding
Smokers
Women over 35 (risk of stroke) with risks of stroke eg obese, FH, MI, vascular disease
Ob
Side effects of CHC
Hypertension
Coronary artery disease
Lipid metabolism decreases
Carbohydrate metabolism decreases
DVT
Side effects of progesterone only hormonal
Increased appetite which may result in weight gain
disturbance of cyclic bleeding and amenorrhoea
delay in return to fertility on discontinuation
acne, chloasma, greasy hair
loss of libido, dry vagina
mood changes
Management of bleeding on oral contraceptives
Exclude gynae pathology first
Biphasil (1 daily x 21 may be repeated x 1 or 2 cycles)
Premarin (1,25mg daily x 21 may be repeated x 1 or 2 cycles)
Light bleeding may respond to lower dose COCs Nordette/ Oralcon ( 1
daily x7 days)
Non steroidal anti in lammatory drugs such as Ibuprofen may be used
if oestrogen is contraindicated
Which contraceptives affect breast milk
COC
