Contraceptives and Pregnancy

jmanderson's version from 2015-12-08 21:29

pregnancy and contraception


Question Answer
unintended pregnancy risk factorsteens < 15 yo, low education/income, cohabitating women, unmarried women, black women
the obstetric hx includesprior pregnancies including losses, type of delivery (vag v. c-wection), M/F, birth wt, complications (HTN, DB, preterm)
GPTPAL meansGravid (total pregnancies), Para (total births after 20 wk gestation), Term (after 37 wk gestation), Preterm (before 37 wk), Abortion (loss before 20 wk), Living children
G5 P13125 pregnancies, 1 term birth, 3 preterm births, 1 abortion, 2 living children
menstrual cycle length > 35 doligomenorrhea
pregnancy occurred earlier or later (>2y) than plannedmistimed pregnancy
pregnancy occurred when no (more) children were plannedunwanted pregnancy
% failure rates of different contraceptive methodsno method > periodic abstinence > withdrawal > condoms > OCP’s > dep provera > nuva ring > patch > IUD > impalnon/nexplanon > sterilization > vasectomy
% failure rates of perfect v. typical use of contraceptivesperfect < typical use
health risks w/ unintended pregnancyless likely to get prenatal care, more likely to abuse etOH/tobacco during pregnancy, higher assoc. w/ physical abuse, lower rates of breastfeeding
most common birth control in US in F > 30 yotubes tied
most common AE of getting tubes tiedregret
induced production of WBCs, enzymes, prostaglandins in endometrial cavity (toxic to sperm, may affect implantation)copper T 380a IUD MOA
most effective form of emergency contraception (good compliance, good for 10 y)copper T 380a IUD (ParaGard)
most important advantage of male condomsSTD prevention
take w/in 72 h of unprotected sex, suppresses ovulation, may prevent fertilization/egg-implantationplan B pill (Levonorgerstrel)
long acting reversible contraceptive that releases leveonorgestrel to thicken cervical mucus, reduce implantation, effect spermMirena
IUD lasts 5 yMirena
IUD lasts 3 ySkyla
OCPs CIsDVT/PE, CVA/CAD/IHD, DM w/ vascular dz, breast CA, liver adenoma, hepatitis, cirrhosis, MIGRAINE HEADACHE w/ aura, surgery w/ PROLONGED IMMOBILIZATION (stasis increased risk for clotting), >45 yo and HEAVY SMOKER, BP > 160/100 mmHg
OCPs AEsno STI protection, daily admin, menstrual cycle changes, N/V, HA, decreased libido, HYPERCOAGUABILITY (though pregnancy increases your risk for clotting even more), GB dz
Patch AEshigher dose estrogen --> VTE, DVT, allergic rxn
Vaginal Ring AEsfalling out, discomfort, nausea, HA
Depo-provera AEswt gain, spotting
Nexplanon (estrogenal arm implant) AEsirregular periods
Mirena AEsdysmenorrhea (mild)
Paragard AEsheavier flow