Contraception LARC Flashcards Preview

Reproduction > Contraception LARC > Flashcards

Flashcards in Contraception LARC Deck (36)
1

What is the world's most widely used contraceptive method

withdrawal

2

What are the ascects of 'natural' family planning

Body temp
cervical mucous
cervical position
'standard days'
Breast feeding

3

What happens to body temperature when a woman is ovulating

it increased by more than 0.2 degrees celcius
sustained for three days after at least six days of lower temp

4

What happens to cervical mucous around ovulation

thick and stick post ovulation
occurs for at least three days after a thinner, watery mucous

5

What is the cervical position when fertile

high in vagina, soft and open

6

When are the most fertile days in a standard 28 day cycle

8 to 18

7

how effective is breast feeding as a contraceptive

if three criteria are me it is 98 percent effective
1. exclusively breast feeding
2. less than 6/12 post natal
3.amenorrhoeic

8

What is the pearl index

represents no of contraceptive failures per 100 women users/year-
(no of accidental pregnancies x 1200)divided by total months of exposure

9

What are the options for LARC or VLARC?

LARC- injectable contraception ie depo provera
VLARC- IUD, IUS, implant

10

What is the primary mode of action of depo provera

inhibits ovulation
progesterone only

11

What other effects does depo provera have?

effects cervical mucus and endometrium

12

What is the peal index of depo provera

0.3 percent

13

What are the side effects of depo provera

weight gain
delay in return of fertility
irregular bleeding
risk osteoporosis

14

What are the risk factors for osteoporosis

anorexia/underweight
steroid use
xs alcohol
immobile
FHx
Smoking
Low trauma fracture
Chronic condition eg hypothyroid, coeliac, RA, hyperparathyroid, IBD, renal disease

15

When can depo be started

Up to and including day 5 of a cycle without need for additional protection
Beyond day 5 a woman con start depo providing she is reasonably certain she is not pregnant and uses condoms/abstains for 7 days

16

What is 'reasonably certain' a woman isn't pregnant

no sex since last period
consistant with contraception
- less than seven days of a normal period
- less than than four weeks post partum
breast feeding with criteria met
negative pregnancy test more than 3 weeks since UPSI

17

when can depo be given post partum

up to day 21

18

when can depo be given after TOP

up to day five

19

What is the IUD

t shaped non hormonal device containing copper and plastic (some silver etc is used to prevent corrosion)
gold standard - 380mm2 copper

20

what is the primary mode of action of the IUD

prevents fertilisation
creates inflammatory response in endometrium

21

How long is the IUD licenced to be kept in for

5-10 years

22

What is the pearl index of the IUD

0.5 percent (1 in 200)

23

What is the IUS?

Two types- 52mg LNG-IUS (20mcg levonorgestrel daily, decreasing to 10ug per day at 5 years) liscenced for 5 yrs
- 13.5mg LNG-IUS (14ug per day for first 24 days, decreasing to 5ug per day at 5 years) liscenced for 3 years
progesterone only device

24

what is the primary mode of action of the IUS

effects implantation
endometrium is rendered unfavourable for implantation

25

what is the pearl index of the IUS

0.2 percent (1 in 500)

26

What are the contraindication to IUD/IUS

current pelvic infection
abnormal uterine anatomy
pregnancy
sensitive to constituents
gestational trophoblastic disease where bhcg levels abnormal
endometrial cancer
cervical cancer awaiting treatment

27

When can an IUD be fitted

Within in the first 7 days of a period
Any time provide reasonably certain not pregnant
Up to 5 days after UPSI ( for EC)
OR
Up to 5 days after predicted date of ovulation
Either within 48 hrs or > 4 weeks post partum
Immediately post TOP ( if products of conception seen)

28

When can an IUS be fitted?

Within the first 7 day of a period
Any time provide reasonably certain not pregnant
NOT used for EC
If fitted out with first 7/7- use condoms for first 7/7
Either with in 48 hrs or > 4 weeks post partum
Immediately post TOP ( if products conception seen)

29

What are the side effects of the IUD

heavy prolonged menses
pain, infection PID risk increased in first 20 days
Perforation
Expulsion
Ectopic pregnancy risk

30

What are the side effects of IUS

Lighter, less frequent bleeding
Pain, infection PID increased in first 20 days
Perforation 1-2/1000
Expulsion- same as IUD
Ectopic risk??
…….Overall 0.01 to 0.1 per 100 women yrs
Maybe higher with lower does version??
failure

31

What is the implant

single, non biodegradable subdermal rod
can be used for 3 yrs
contains 68mg of eng- releases 60/70ug per day in weeks 5-6
25-30ug per day end of 3rd year use

32

what is the primary mode of action of the implant

inhibition of ovulation
other - effects endometrium and cervical mucous

33

what is the pearl index of the implant

0 to 0.1 percent

34

when can an implant be fitted

No need for additional precautions:
Within first 5 days of cycle
Up to day 5 post first/second trimester abortion
On or before day 21 postpartum

Need for additional precautions first 7 days
If it is reasonably certain she is not pregnant
“quick start” after emergency contraception
Off licence

35

When can you switch to the implant from another form of contraception

immediately effective if fitted after last active pill pack taken or depo still within 14 weeks
if weeks 2-3 of coc, patch or ring
need additional contraception if
- change from POP or IUS
-switching from non hormonal method (IUD)

36

what are the side effects of the implant

irregular bleeding
wt gain
acne
nerve damage
deep insertion