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Flashcards in LARC Deck (27):
1

Natural family planning methods?

Basal body temp

Cervical mucous

Cervical position

Standard days

Breast feeding

2

What is basal body temperature and when is it measured?

Taken before rising in the morning

BBT rises after ovulation due to increase in progesterone

Increase in >0.2 degrees C, sustained for 3 days or at least 6 days of lower temp

3

How does cervical mucous change after ovulation?

Thick and sticky post ovulation

For at least 3 days after thinner watery mucous

4

How does cervical positioning change when fertile and infertile

Fertile- High in vagina, soft and open

Infertile- Low in vagina, firm and closed

5

In a 28 day cycle, which days are women most fertile?

8 to 18

6

What is the UKMEC?

UK medical eligibility criteria for contraception

7

How many classifications are there in the UKMEC and what do they represent?

1) No restricition to method

2) Advantages outweigh risks

3) Risks outweigh advantages

4) Unacceptable risk

8

How does the depo provera injection work?

Primarily inhibits ovulation

Also effects mucous and and endometrium

9

How often is depo given?

Every 13 weeks, lasts for 14

10

What examinations are carried out before the depo is given

BP and BMI
Smear status
Check risk for Osteoporosis

11

When do you start depo?

Up to and including day 5 of the cycle without need for any extra contraception

12

What happens if you start the depo beyond day 5?

Can start at any other time providing "reasonably certain" she is not pregnant

Needs to use condoms or abstain for 7 days

13

What criteria need to be met to be reasonably certain someone is not pregnant? (5)

Any one of
- Consistent use of reliable contraception
- <7 days since last normal period
-< 4 wks post partum (not breast feeding)
- Fully breastfeeding, amenorrhoeic and <6m post partum
-Neg preg test and >3wks since UPSI

14

Side effects of depo?

Weight gain

Delay in return of fertility

Irregular bleeding

Possible Osteoporosis risk

15

What is an IUD?

A T shaped device containing copper and plastic-non hormonal

16

Primary mode of action of IUD?

Prevents fertilisation

Causes inflammatory response in endometrium

17

What is the IUS?

A hormonal version of the IUD coil

Releases progesterone

18

How does the IUS work?

Primarily

Effects implantation

Endometrium rendered unfavourable

Effect on cervical mucous

19

IUD/IUS contraindications

PID
Abnormal uterus anatomy
Pregnancy
Sensitivity to constituents
Endometrial or cervical Cancer

20

When can IUD be fitted>

Within 1st 7 days of period

Anytime providing not pregnant

Up to 5 days after UPSI (For EC)

Up to 5 days after predicted ovulation

Within 48 hours or >4weeks post partum

Immediately post TOP

21

When can IUS be fitted?

Same as IUD, except must use condoms for 7 days if after 1st 7 days

22

Side effects of IUD?

Heavy menses
Pain and PID
Perforation
Expulsion
?Ectopic risk

23

Side effects of IUS?

Lighter bleeding
Pain and PID
Perforation
Expulsion
?Ectopic

24

What is the implant?

Single subdermal rod which lasts for 3 years

-Releases progesterone

25

How does implant work?

Inhibits ivulation

Effects cervical mucus and endometrium

26

When can implant be fitted?

First 5 days of cylce
5 days post first/second trimester abortion
on or before day 21 post partum

27

Side effects of implant?

Irregular bleeding
Wt gain
Acne

Nerve damage/vascular injury