ABOG Complex Family Planning flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Copper IUD emergency contraception

A copper IUD inserted within 5 days of unprotected intercourse is the most effective emergency contraceptive, with failure rates below 0.1%.

Levonorgestrel emergency contraception

Oral levonorgestrel 1.5 mg is approved within 72 hours of unprotected intercourse; efficacy declines with higher body weight and when ovulation is imminent.

Ulipristal acetate EC

Ulipristal 30 mg oral is effective up to 120 hours after unprotected intercourse and may be more effective than levonorgestrel, especially with obesity.

Quick start contraception

Starting a method immediately after excluding pregnancy; backup is needed for 7 days with combined hormonal contraception or DMPA and 2 days with progestin-only pills.

DMPA fertility return

After the last depot medroxyprogesterone acetate injection, ovulation may take up to 10 months to return; this delay is not harmful and does not require limiting duration.

Migraine with aura MEC

Combined hormonal contraception is WHO MEC category 4 for migraine with aura because of increased ischemic stroke risk; progestin-only and intrauterine methods are generally safer.

IUD perforation rate

Uterine perforation occurs in approximately 1 per 1,000 IUD insertions; expulsion occurs in 2–10% and infection risk is highest in the first 20 days.

Mifepristone mechanism

Mifepristone is a progesterone receptor antagonist that sensitizes the uterus to prostaglandins and causes decidual necrosis and cervical softening.

Medication abortion regimen

Mifepristone 200 mg orally followed 24–48 hours later by misoprostol 800 mcg buccal or vaginally; approved through 70 days and effective through 77 days.

Aspiration abortion prophylaxis

Doxycycline 200 mg orally before surgical abortion reduces the risk of post-procedural pelvic infection and is recommended by major guidelines.

Rh immunoglobulin dosing

Give anti-D immune globulin 50 mcg before 12 weeks and 300 mcg after 12 weeks to Rh-negative, unsensitized patients undergoing abortion or pregnancy loss.

Post-abortion LARC

An IUD or implant can be placed immediately after an abortion; ovulation may return within 2 weeks, so contraception should be addressed before discharge.

Septic abortion management

Septic abortion presents with fever, uterine tenderness, and purulent discharge; treatment requires broad-spectrum antibiotics and urgent uterine evacuation.

Mifepristone REMS

Mifepristone is dispensed under an FDA risk evaluation and mitigation strategy; requirements have changed and vary by state, so clinicians must verify current rules.

Discriminatory zone hCG

An intrauterine gestational sac should be visible on transvaginal ultrasound when the serum hCG exceeds about 3,500 mIU/mL; absence raises concern for ectopic pregnancy.

Methotrexate ectopic criteria

Methotrexate is an option for hemodynamically stable ectopic pregnancy with an unruptured mass under 4 cm, no fetal cardiac activity, and hCG under 5,000 mIU/mL.

Ectopic hCG follow-up

After methotrexate, measure hCG on days 4 and 7; a decline of at least 15% between days 4 and 7 indicates adequate response, with continued weekly monitoring.

Recurrent pregnancy loss

Recurrent pregnancy loss is typically defined as two or three or more consecutive losses; evaluation includes karyotype, antiphospholipid antibodies, uterine imaging, and thyroid testing.

Complete mole surveillance

After molar pregnancy evacuation, follow hCG to zero and use reliable contraception during surveillance to prevent pregnancy-related hCG confusion and reduce gestational trophoblastic neoplasia risk.

Interpregnancy interval

An interval shorter than 18 months between birth and next conception is associated with preterm birth and low birth weight; postpartum contraception helps optimize timing.

WHO MEC categories

Category 1 means no restriction, 2 advantages outweigh risks, 3 risks usually outweigh advantages, and 4 represents unacceptable health risk for the condition.

SLE antiphospholipid contraception

In SLE with positive antiphospholipid antibodies, combined hormonal contraception is category 4 due to thrombosis risk; copper IUD is category 1 and progestin-only methods are options.

Enzyme-inducing antiseizure drugs

Enzyme inducers such as carbamazepine and phenytoin can reduce combined pill and progestin-only pill efficacy; DMPA and copper IUD are unaffected.

Breast cancer contraception

During active breast cancer, all hormonal contraception is WHO MEC category 4; the copper IUD is category 1 and is the preferred reversible option.

Lamotrigine and CHC

Combined hormonal contraception lowers lamotrigine levels and may increase seizure frequency; use alternative contraception or monitor lamotrigine levels and adjust dose.

Diabetes vascular disease MEC

Diabetes with vascular disease or end-organ damage makes combined hormonal contraception category 3 or 4; progestin-only methods and IUDs are generally preferred.

Hyde Amendment

The Hyde Amendment restricts federal Medicaid funding for abortion except in cases of rape, incest, or life endangerment, limiting access for low-income patients.

Belmont Report principles

The Belmont Report established respect for persons, beneficence, and justice as core ethical principles for human subjects research, guiding informed consent and IRB review.

Reproductive justice

A framework asserting rights to have children, not have children, and parent children in safe environments, while addressing structural inequities in reproductive health care.

Intention-to-treat analysis

Analyzing participants according to randomized assignment, regardless of adherence, preserves randomization and reduces bias in clinical trials.

Dobbs v Jackson

The 2022 Supreme Court decision overturned Roe v Wade and returned abortion regulation to states, leading to varied bans and gestational limits.

Title X confidentiality

Title X family planning programs must provide confidential services and may not require parental consent for minors, though state reporting laws may apply.