UKMEC

Question 1

How was it developed?

Answer 1

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

Question 2

Liver tumours. Benign or malignant what’s the only ukmec1?

Answer 2

Cu IUD

Question 3

Anaemias-what’s always a UKMEC 2?

Answer 3

Cu IUD

Only other non UKMEC 1 is UKMEC 2 CHC in Sickle Cell disease

Question 4

Positive anti-phospholipid antibodies CHC whether SLE or not is UKMEC….

Answer 4

4

Question 5

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….

Answer 5

1 for everything

Question 6

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…

Answer 6

1 for everything

Question 7

What UKMEC is not

Answer 7

Best methods for individual
Do not consider efficacy

Is only about safety

Question 8

When ukmec talks about continuation what does it mean?

Answer 8

When someone on a method develops a new condition and you are considering continuing it

Question 9

When ukmec talks about initiation what does it mean?

Answer 9

Starting the method in someone already known to have a condition

Question 10

What does ukmec 2 mean in practice?

Answer 10

Use but may need more careful follow up

Question 11

What does ukmec 3 mean in practice?

Answer 11

Can use but may need expert clinical judgement/refer to specialist since method not usually recommended unless other methods unacceptable or unavailable

Question 12

What does ukmec 4 mean in practice?

Answer 12

Unacceptable risk should not be used

Question 13

What does ukmec 1 mean?

Answer 13

No restriction

Question 14

Why is IUC ukmec 2 after 2nd trimester abortion but ukmec 1 after 1st trimester?

Answer 14

May be Greater expulsion risk

Question 15

What ukmec is IUC post complicated organ transplant?

Answer 15

3 initiation
2 continuation

Question 16

What ukmec is lng iud in vascular disease and multiple RF CVD?

Answer 16

2

Vascular disease includes TIA, PVD,angina, hypertensive retinopathy

Question 17

What ukmec is LNG IUD continuation in Stroke/TIA/IHD

Answer 17

3
May be continued but clinical judgement re risk needed

Question 18

DVT/Dyslipidaemia/fvleiden etc/major surgery/AF/any migraine are what ukmec LNG?

Answer 18

2

Question 19

Complicated congenital or valvular heart disease and impaired cardiac function are what ukmec both cu and lng?

Answer 19

2

Question 20

Insertion of any coil with long QT?

Answer 20

3

(Is 1 to continue risks relate to insertion procedure)

Question 21

Unexplained vaginal bleeding suspicion serious is what uk mec for insertion coil?

Answer 21

Ukmec 4

(2 to continue)

Question 22

Cu IUD is what ukmec in endo/dysmennorhea?

Answer 22

2

Question 23

Cervical cancer what ukmec both coils?

Answer 23

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

Question 24

Breast cancer and lng IUD?

Answer 24

Ukmec 2 undiagnosed mass
Ukmec 3 prev breast cancer
Ukmec 4 current breast cancer

Question 25

Endometrial cancer and either coil?

Answer 25

I:4
C:2

Infection/perforation/bleeding risk

Question 26

What ukmec either coil cd4 <200

Answer 26

I:3
C:2

Question 27

DM ukmec for lng IUD

Answer 27

2-regardless insulin/type/complications

Question 28

GB disease/COC cholestasis benign focal nodular hyperplasia lng IUD

Answer 28

2

Question 29

Decompensated cirrhosis, heatacellular adenoma, hepatacellular carcinoma lng iud?

Answer 29

3

Question 30

Do P only methods have any ukmec restrictions relating to surgery?

Answer 30

They are all ukmec 2 for major surgery > 30 mins with immobility but otherwise ukmec 1

Question 31

What is age restriction ukmec for p only methods?

Answer 31

DMPA is a 2 < 18 and > 45

(Unlike coils which are a 2 <20)

Question 32

Are any of P only methods anything except a 1 postnatal?

Answer 32

Yes DMPA is a 2 < 6 weeks if BF or RF VTE

If no RF VTE is 1 after 3 weeks

Question 33

P only methods multiple RF CVD any restrictions?

Answer 33

DMPA is a 3 others are 2