Emergency Contraception

Question 1

What age group has the highest rates of TOP?

Answer 1

20-24year olds

Question 2

What are the terms of the abortion act 1967?

Answer 2

needs 2 registered medical practitioners to sign off; must take place in NHS hospital

Question 3

What form must be filled out for an abortion?

Answer 3

certificate A (HSA1)

Question 4

What form must be filled in within 24 hours of an emergency abortion?

Answer 4

certificate B (HSA2)

Question 5

What forms must be completed and sento t the CMO within 7 days of the abortion?

Answer 5

HSA4

Question 6

What is the most common ground for termination used in certificate A?

Answer 6

pregnancy has not exceeded 24th week and continuane of pregnancy would invovle risk, greater than if pregnancy terminated, of injury to physical or mental health of pregnant woman

Question 7

How long does it take to be referred for TOP consultation?

Answer 7

2 weeks

Question 8

When is the legal limit for social TOP?

Answer 8

23 weeks 6 days

Question 9

What is the limit for medical termination in Tayside?

Answer 9

18 week and 6 days

Question 10

What is the limit for surgical termination for Tayside?

Answer 10

upto 12 weeks

Question 11

What is defined as early medical temrination?

Answer 11

upto 9 weeks

Question 12

What is defined as late medical termination?

Answer 12

9-12 weeks

Question 13

What is mid-trimester termination?

Answer 13

12-24 weeks

Question 14

What is the first stage in medical TOP?

Answer 14

oral mifepristone 200mg

Question 15

What is mifepristone?

Answer 15

anti-progesterone

Question 16

What is the second stage of medical TOP?

Answer 16

vaginal or oral prostaglandin eg misoprostol

Question 17

HOw long after the first stage does the second stage of TOP take place?

Answer 17

24-48hours

Question 18

What option is there for early medical TOPs~?

Answer 18

complete 2nd part at home

Question 19

What is required for late-mid-trimester medical TOPs?

Answer 19

repeated doses of prostaglandin 3 hourly

Question 20

What is the surgical option 6-12 weeks?

Answer 20

vacuum aspiration

Question 21

What is the surgical option available in London between 13-24 weeks?

Answer 21

dilatation and evacuation

Question 22

What tx is required before surgical TOP?

Answer 22

cervical priming with vaginal prostaglandin

Question 23

What is manual vacuum aspiration?

Answer 23

new alternative for early TOP performed under LA

Question 24

What are the complications of TOP?

Answer 24

pain; haemorrhage; infection; imcomplete/failed; uterine perforation; cervical trauma; anaesthetic complications; uterine rupture

Question 25

How long after TOP should a repeat UPT be done?

Answer 25

2-3 weeks

Question 26

What contraceptives can be started immediately after TOP?

Answer 26

pills; injection; implant; IUD- depends

Question 27

What is the mid-cycle pregnancy risk following UPSI?

Answer 27

around 30%

Question 28

After how many missed COC should EC be taken?

Answer 28

more than one

Question 29

What are the oral methods of EC?

Answer 29

LNG-EC and UPA-EC

Question 30

What is the difference between LNG-EC and UPA-EC?

Answer 30

LNG upto 72hours post UPSI whereas UPA upto 120hours

Question 31

What intrauterine method is available for EC?

Answer 31

copper IUD

Question 32

What is the mode of action of oral EC?

Answer 32

delay ovulation

Question 33

Does LNG or UPA have a higher pregnancy rate after use?

Answer 33

UPA

Question 34

When is LNG most effective?

Answer 34

first 24 hours

Question 35

What is UPA?

Answer 35

anti-progestogen

Question 36

What is LNG?

Answer 36

high dose progestogen

Question 37

Which oral EC can work during LH surge but not after peak?

Answer 37

UPA

Question 38

When should UPA be avoided?

Answer 38

if wishing to start quick-start contraception- must delay for 5 days; if hormonal contraception has been used in past 7 days; severe asthma

Question 39

What is the effectiveness of the copper IUD compared with oral ECs?

Answer 39

10x more effective

Question 40

What are the mode ofactions of the copper IUD?

Answer 40

toxic to sperm and ovum; anti-implantation

Question 41

When can the copper iuD be inserted?

Answer 41

upto 120 hours post-UPSI; upto 5 days after earlist expected date of ovulation

Question 42

When do most pregnancies implant after fertilisation?

Answer 42

8-10days

Question 43

How often can levnorgestrel vs ulipristral be given in a cycle?

Answer 43

LNG- repeatedly; ulipristal- once

Question 44

What is the difference in time effectiveness between LNG and ulipristal?

Answer 44

LNG is time-dependent whereas ulipristal is not

Question 45

What drugs can ulipristal acetetate not be given with?

Answer 45

liver enzyme inducers; drugs reducing gastric pH; less effective if on hormonal contraception

Question 46

Is ulipristal suitable whilst breastfeeding?

Answer 46

CI for a week