Emergency contraception - — Health Education North East：紧急避孕-健康教育北东.pptVIP

Emergency Contraception (EC) Emergency Contraception Clinical Effectiveness Unit August 2011 /pdfs/CEUguidanceEmergencyContraception11.pdf Emergency contraception (EC) is a method of preventing pregnancy following unprotected sexual intercourse (UPSI) or potential contraceptive failure. Minimum history required Pharmacists can do this so…….. Minimum history required LMP Cycle length (shortest) When did they have sex? Including prior episodes in current cycle and any EC? Drug history Allergies Would a pregnancy be disasterous? 3 options Copper Intrauterine device (IUD) Levonorgestrel 1.5mg (Levonelle One Step or Levonelle 1500) LNG Ulipristal Acetate 30mg (ellaOne) UPA Timing and efficacy Copper IUD Failure rate considerably lower than 1% and not affected by timing (1963 women and no pregnancies in first month) Can be fitted up to120 hours after first episode of UPSI or up to 120 hours from the earliest estimated date of ovulation A Cu-IUD can be fitted in good faith, providing appropriate steps have been taken to try and establish earliest estimated date of ovulation Timing and efficacy LNG Incompletely understood action ?inhibits ovulation May delay ovulation by 5 days No better than placebo at suppressing ovulation when given immediately prior to ovulation Licensed for 72 hours. May be effective up to 96 hours. Quicker the better. Cycle timing probably alters efficacy. Can be used more than once in cycle (If more than 3 weeks - pregnancy test first) Timing and efficacy UPA Licensed up to 120 hours after UPSI Thought to inhibit or delay ovulation No apparent decline within that time period Glasier study 2010 randomised, non-inferiority trials showing UPA no less effective and non-significant trend towards lower pregnancy rates with UPA Should not be used more than once in cycle or if there has been another episode of UPSI outside 120 hr window Copper IUD Can be fitted up to 120 hours after first episode of UPSI Can be fitted up to 120 hour