最新Emergency Contraception：紧急避孕教学讲义PPT.ppt

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1、EmergencyContraception：紧急避孕IsthereanytimeEmergencyContraceptionisnotnecessarybecausethereisnorisk?Isitsafe?WillIeverdoanyharm?WhyshouldIdiscussIUDifIcan’tfitone?IsUPAworththepricedifference?Doesweightmatter?HowtodecidewhichECtoofferinclinicandwhichisbestWh

2、atisthemostimportantquestiontoaskawomanwhorequestsemergencycontraception?Ihadsextwonightsagowithoutprotection.I’vedoneitbeforeandgotawaywithit.AmIatanyriskofpregnancythistime?IsitworthmegoingthroughthetroubleofhavinganIUDfitted?IsitworththeextracostofUPA?G

3、lasier(Contraception2011)Limitofefficacyreachedat:70kg/BMI26forLNG88kg/BMI35forUPAHowdoyouinterpretBMIdataintheclinicalscenario?ThereissomeevidencetosuggestthatwomenwithaBMI>30mayhaveahigherfailurerateoforalECSoyoumaywanttoconsideranIUDasthisisnotaffected

4、TheevidencesuggeststhatUPAmaybelessaffectedNoideaifitisdoserelatedIsitweightorBMIrelated?AtwhatBMI/weightshouldwestarttosaythis?NeedmoreevidenceNeverdenyoralECduetoBMIMHRApositionreECandweight/BMINochangetoclinicalpracticeIsourchoicethesame?Yes!(But…..)Iha

5、dUPSIlastnightIhadUPSIlastnightCasestudiesBelindaA31yearoldnullipattendsclinicrequestingEmergencycontraception.LSI4+daysago;UPSI.NootherUPSIthiscycle.LMP22daysagoHowwouldyoumanagethispatient?Whatotherpieceofinformationwouldbeusefulandwhy?Whatmethodsaresuit

6、ableforher?DiscussprosandconsofeachWhatelsemightberelevant?Cassie26yearoldladyattendsforRepeatCOC.Hasrunoutofpills,isduetorestarttoday.Missed1pillatendoflastpacket.2episodesofUPSIinPFI.2daysand6daysagoDoessheneedEC?Thenurseseeingherstatesthatsheiscurrently

7、“day7ofhercycle”.Commentonthis.AssumingyouconsiderhertohavehadUPSIbecauseofthemissedpillswhatmethod(s)ofECaresuitable?Shehashad2episodesofUPSI–howdoesthisaffectyourdecisionWhatisamissedpill?HowmanypillscanyoumissbeforeneedingEC?CasestudiesWhich(ifany)ECwou

8、ldyougive?Anya22yearoldandusesnocontraception.Shetakescarbamazepineforepilepsy.ShehadUPSIonD22ofa28daycycle.ThisisheronlySIthiscycle.PresentsonD24(i.e.48hourslater).Mavis48yearwomanwhotakesMicronorwhenshereme