UKMEC Flashcards
How was it developed?
Identify topics for review:
Consultation with stakeholders
Search of members enquiry service for common themes
Comparison with USMEC and WHOMEC
Guideline steering group established and agreed scope (CEU plus external)
Guideline development group (steering group plus experts)
Proposed revisions based on systematic reviews plus expert if needed as evidence lacking
Recommendations agreed by formal consensus
Draft reviewed and feedback from GDG
Revised draft to stakeholders and experts for peer review
Revisions requiring consensus made by GSG
CEU editorial revisions and approval final version
Liver tumours. Benign or malignant what’s the only ukmec1?
Cu IUD
Anaemias-what’s always a UKMEC 2?
Cu IUD
Only other non UKMEC 1 is UKMEC 2 CHC in Sickle Cell disease
Positive anti-phospholipid antibodies CHC whether SLE or not is UKMEC….
4
Mild cirrhosis, hepatitis carrier or chronic, thyroid disorders, history of GDM, non pelvic TB, high risk HIV, prev PID, fibroids without distortion any parity, all methods are UKMEC….
1 for everything
Ovarian cancer, FH breast cancer or benign breast condition, ectropion, GTD undectable HCG, benign ovarian tumour, depression, epilepsy, prev ectopic, pelvic surgery, post 1st trim abortion are all ukmec…
1 for everything
What UKMEC is not
Best methods for individual
Do not consider efficacy
Is only about safety
When ukmec talks about continuation what does it mean?
When someone on a method develops a new condition and you are considering continuing it
When ukmec talks about initiation what does it mean?
Starting the method in someone already known to have a condition
What does ukmec 2 mean in practice?
Use but may need more careful follow up
What does ukmec 3 mean in practice?
Can use but may need expert clinical judgement/refer to specialist since method not usually recommended unless other methods unacceptable or unavailable
What does ukmec 4 mean in practice?
Unacceptable risk should not be used
What does ukmec 1 mean?
No restriction
Why is IUC ukmec 2 after 2nd trimester abortion but ukmec 1 after 1st trimester?
May be Greater expulsion risk
What ukmec is IUC post complicated organ transplant?
3 initiation
2 continuation
What ukmec is lng iud in vascular disease and multiple RF CVD?
2
Vascular disease includes TIA, PVD,angina, hypertensive retinopathy
What ukmec is LNG IUD continuation in Stroke/TIA/IHD
3
May be continued but clinical judgement re risk needed
DVT/Dyslipidaemia/fvleiden etc/major surgery/AF/any migraine are what ukmec LNG?
2
Complicated congenital or valvular heart disease and impaired cardiac function are what ukmec both cu and lng?
2
Insertion of any coil with long QT?
3
(Is 1 to continue risks relate to insertion procedure)
Unexplained vaginal bleeding suspicion serious is what uk mec for insertion coil?
Ukmec 4
(2 to continue)
Cu IUD is what ukmec in endo/dysmennorhea?
2
Cervical cancer what ukmec both coils?
Awaiting treatment is 4 to start due to concern over bleeding and infection (2 Continue)
Trachelectomy is 3
Note CIN is a 2 theoretical concern re P
Breast cancer and lng IUD?
Ukmec 2 undiagnosed mass
Ukmec 3 prev breast cancer
Ukmec 4 current breast cancer
Endometrial cancer and either coil?
I:4
C:2
Infection/perforation/bleeding risk
What ukmec either coil cd4 <200
I:3
C:2
DM ukmec for lng IUD
2-regardless insulin/type/complications
GB disease/COC cholestasis benign focal nodular hyperplasia lng IUD
2
Decompensated cirrhosis, heatacellular adenoma, hepatacellular carcinoma lng iud?
3
Do P only methods have any ukmec restrictions relating to surgery?
They are all ukmec 2 for major surgery > 30 mins with immobility but otherwise ukmec 1
What is age restriction ukmec for p only methods?
DMPA is a 2 < 18 and > 45
(Unlike coils which are a 2 <20)
Are any of P only methods anything except a 1 postnatal?
Yes DMPA is a 2 < 6 weeks if BF or RF VTE
If no RF VTE is 1 after 3 weeks
P only methods multiple RF CVD any restrictions?
DMPA is a 3 others are 2
