Contraception and termination of pregnancy Flashcards Preview

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Flashcards in Contraception and termination of pregnancy Deck (55)
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1

For how long do ovum and sperm survive in the female genital tract?

Ovum survives for up to 24 hours

Sperm survives for up to 5 days

2

What factors are monitored for natural family planning?

Basal body temperature
Cervical mucous
Cervical position
Standard/ fertile days
Breastfeeding

3

How can basal body temperature be used to monitor fertility?

Taken before rising in the morning

Increase of >0.2 sustained for at least 3 days after at least 6 days of lower temp indicates ovulation

4

Describe the position of the cervix when fertile vs when infertile

Cervix is high in the vagina, soft and open when fertile

Cervix is low in the vagina, firm and closed when less fertile

5

What days of the menstrual cycle are the most fertile?

8 to 18

6

What criteria must be met for breastfeeding to be considered an effective method of contraception?

Exclusively breast feeding

Less than 6 months post natal

Amenorrhoeic

7

What methods of contraception are combined hormonal methods and which contain progesterone only?

Combined:
COC, patches, vaginal ring

Progesterone only:
POP, implant, depo injection

8

What methods of emergency contraception may be available to patients?

Copper IUD

Oral medications: UPA or LNG

9

What is the most effective method of emergency contraception?

Copper IUD

10

When can a copper IUD be installed for emergency contraception and what is the reason for this?

5 days after UPSI or up to 5 days after the earliest expected date of ovulation

This is because pregnancy doesn't implant within the first 5 days - so this is a safe time to insert

11

What are the differences between UPA and LNG, the two oral methods of emergency contraception?

UPA
Anti progestogen
Can work during the LH surge but not after the peak
Up to 5 days post UPSI

LNG
High dose progestogen
Works until just before the LH surge
Up to 3 days post UPSI

12

In which circumstances should UPA, an oral emergency contraceptive NOT be used?

If hormonal contraception has been used in the last 7 days

If the patient has severe asthma, uncontrolled on oral steroids

13

How do combined methods of contraception, such as the pill, patch or ring work?

Contain both oestrogen and progestogen which act by negative feedback on the pituitary gland to inhibit ovulation, make cervical mucus thick and sticky and make the endometrium thinner

14

At what body weight would the combined hormonal patch not be recommended?

>90kg

This is because there is possible decreased efficacy

15

Which method of contraception has the lowest failure rates?

The contraceptive implant

16

Which methods of contraception are considered short-acting and which are considered long-acting?

SHORT ACTING
Combined hormonal contraception

LONG ACTING
Contraceptive implant
Depo injection
IUS
Cu IUD

17

What are some of the risks associated with methods of combined hormonal contraception?

Venous thrombosis

Arterial thrombosis

18

What is the treatment for acne and hirsutism which contains a high does of oestrogen and therefore also acts as a contraceptive?

Cyproterone acetate

19

How should a patient on CHC be reviewed?

Check BP at 3 months then either 6 monthly or annually

20

What is the cut off limit for BP for patients taking a combined hormonal method of contraception?

140/90

21

Migraine with aura is a contraindication for the use of which contraceptive?

Combined oral contraceptive pill

22

What are the risks and protective benefits for cancers associated with combined hormonal contraception?

Increased risk of breast cancer and cervical cancer

Protection against ovarian and endometrial cancers

23

The combined hormonal contraceptive is associated with being of benefit for which conditions?

Acne

PCOS

Premenstrual syndrome

Ovarian and endometrial cancers

24

When can the CHC, POP, subdermal implant or DMPA all be started?

Within the first 5 days of regular menstruation or anytime in the cycle but should use condoms for the first 7 days

25

When can IUS or Cu-IUD be started?

At anytime in the cycle if there has been no IPSI in the past 3 weeks or since the last period

26

How often is the depo injection given?

Every 13 weeks

27

What are some of the risks of the depo injection?

Increased risk of poor bone mineral density in people who already have bone problems

VTE

Interaction with liver enzyme inducers

28

What may be some of the contraindications to the use of the depo injection?

Age <18 years or >45 years

BMI <20

Malabsorption

Hyperthyroidism

Amenorrhoea

29

How does IUS work?

Effects implantation and mucus

30

How does the Cu-IUD work?

Copper is toxic to the joining of egg and sperm

Inflammatory response in the endometrium