Unplanned pregnancy

Question 1

What are the three forms of emergency contraception in the UK?

Answer 1

Levonelle
EllaOne
IUD

Question 2

How long after UPSI can Levonelle be administered?

Answer 2

Up to 72 hours

Question 3

How long after UPSI can EllaOne be administered?

Answer 3

Up to 120 hours

Question 4

How long after UPSI is a copper coil effective?

Answer 4

Up to 120 hours

Up to 5 days after earliest expected date of ovulation

Question 5

What is the failure rate of levonelle on day 1 after UPSI?

Answer 5

1-2%

Question 6

What is the most commonly performed gynaecological procedure in the UK?

Answer 6

Termination of pregnancy

Question 7

In which age group are the highest rates of termination of pregnancy seen?

Answer 7

Aged 20-24

Question 8

What should be discussed in the initial termination of pregnancy appointment?

Answer 8

Certainty to proceed/discuss alternatives
Ultrasound scan – confirm IUP, determine gestation
Complete medical history
Discuss suitable methods
Written consent for procedure
Bloods obtained (FBC/G&S/rubella +/-BBV)
Optional screening for STI
Counselling re: ongoing contraception

Question 9

When are the surgical options for termination of pregnancy available?

Answer 9

Vacuum aspiration - 6-13 weeks

Dilatation and evacuation - 13-24 weeks

Question 10

At what stage in pregnancy is medical TOP an option?

Answer 10

Early - up to 9 weeks
Late - 9 to 12 weeks
Mid-trimester - 12 - 24 weeks

Question 11

What is involved in a medical TOP (early

Answer 11

Oral mifepristone 200mg
24-48 hours later:Vaginal (or oral) prostagladin e.g. misoprostol, gemeprost
In early pregnancy, this second stage can be carried out at home

Question 12

What is involved in a medical TOP (Late - mid-trimester)?

Answer 12

Repeated doses of prostaglandin 3 hourly (max 5/24 hours)

Question 13

What is the most effective form of emergency contraception?

Answer 13

IUD