Other Flashcards
(72 cards)
importance of contraception postpartum
increased risk for maternal and fetal bad outcomes within first 6 months postpartum
COC postpartum
contraindicated for the first 6 weeks postpartum due to increased risk of VTE
absolute contraindication to COC
current breast cancer
severe decompensated cirrhosis
acute deep vein thrombosis
pulmonary embolism
high risk for recurrence of deep vein thrombosis or pulmonary embolism
major surgery with prolonged immobilization
migraine with aura
systolic blood pressure ≥ 160 mm Hg
diastolic blood pressure ≥ 100 mm Hg
history of ischemic heart disease
known thrombogenic mutations
hepatocellular adenoma
malignant hepatoma
moderately or severely impaired cardiac function
diagnosis of normal or mildly impaired cardiac function within the previous 6 months
patients < 21 days postpartum regardless of breastfeeding status
patients ≥ 35 years of age and smoking ≥ 15 cigarettes/day
history of cerebrovascular accident
complicated valvular heart disease
The most prevalent serious adverse effect of COC
VTE
how to use diaphragm
should be inserted less than 1 hours prior to intercourse up to 6 hours before intercourse and must be kept in place for at least 6 hours after intercourse. If it is placed more than 1 hour before intercourse, another applicator full of spermicide or vaginal pH regulator gel needs to be inserted into the vagina for maximum effect
how to use cervical cap
it can be inserted for up to 6 hours prior to intercourse and does not require reapplication of spermicide if time has elapsed between placement and intercourse
ADE cervical cap and diaphragm
urinary tract infections (especially with diaphragm use during multiple acts of intercourse) and a small risk of toxic shock syndrome
Max amount of time that a cervical cap or diaphragm should be inserted
12–18 hours
should cervical caps or diaphragms be used during menstruation
no
IUD contraindications
bicornuate uterus, septate uterus, uterine fibroids, cervical stenosis, active pregnancy and current or frequent pelvic inflammatory disease
can patients with current fibroids or a history of fibroids have an IUD place
patients with current fibroids or a history of fibroids that do not have severe distortion of the uterine cavity may be able to have an IUD placed, they should be counseled prior to intrauterine device insertion
risk of what illness is increased w IUD
PID
IUD placement
Intrauterine placement should occur at the end of menses or within 7 days after the last menstrual period. If this is not achieved, backup contraception should be used 7 days following placement
duration of 13.5 mg levonorgestrel-releasing intrauterine device
3 years
duration of 19.5 mg levonorgestrel-releasing IUD
5 years
duration of 52 mg levonorgestrel-releasing IUD
8 years
duration copper IUD
10 years
contraindications combined patch
history of thromboembolism, history of an estrogen-dependent tumor, abnormal liver function testing, and individuals with a body mass index ≥ 30 kg/m2
common ADE of combined patch
unscheduled bleeding during the first few cycles, breast tenderness, and application site reactions
application of combined patch
patch is applied weekly for 3 consecutive weeks prior to a patch-free week. The patch can be applied to the buttock, abdomen, or upper torso, and a different site should be used each time a new patch is applied. The patch can be reapplied if it is accidentally detached for < 24 hours. If it is detached for more than 24 hours, a new patch should be applied
Endometriosis
the presence of endometrial tissue outside the uterus
MC location for endometriosis to occur
ovaries
tx endometriosis
NSAIDs or COC
gonadotropin-releasing hormone analogs, such as leuprolide and nafarelin
Danazol, aromatase inhibitors (Anastrazole)
hysterectomy with oophorectomy
laparoscopy for endometriosis
areas of peritoneal endometriosis appear as blue-black powder burn lesions, raised flame-like patches, whitish opacifications, yellow-brown discolorations, translucent blebs, or irregularly shaped islands
