tailieunhanh - Thực hành xử lý sản khoa - Trường hợp 7

Tham khảo tài liệu 'thực hành xử lý sản khoa - trường hợp 7', y tế - sức khoẻ, y dược phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | T CASE 34 K 22-year-old nulliparous woman whose last menstrual period was approximately 2 weeks ago states that she had unprotected intercourse last night. She asks whether anything can be done to prevent her from getting pregnant. She usually uses a condom and foam for contraception. She is in good health. Her blood pressure is 120 70 HR 80 min and temperature 99 E Her heart and lung examinations are normal. The abdomen is nontender and without masses. The pelvic examination reveals a normal anteverted uterus. There are no adnexal masses. The pregnancy test is negative. What is your next step CASE FILES OBSTETRICS AND GYNECOLOGY ANSWERS TO CASE 34 Emergency Contraception Summary A 22-year-old nulliparous woman whose last menstrual period was approximately 2 weeks ago states that she had unprotected intercourse last night. She asks whether anything can be done to prevent her from getting pregnant. She is in good health. Her physical examination is unremarkable. The pregnancy test is negative. Next step Emergency contraception EC high-dose oral contraceptives or progestin . Analysis Objectives 1. Understand that emergency contraception may be used to help prevent an unwanted pregnancy after coitus. 2. Know that high-dose combination estrogen and progestin therapy or high-dose progestin therapy are methods of emergency contraception. Considerations This 22-year-old nulliparous woman is at approximately midcyclc and had an episode of unprotected intercourse the night before. She is a candidate for emergency contraception which is usually effective if given within 72 hr of coitus. Options include high-dose estrogen and progestin pills taken nowand in 12 hr or high-dose progestin-only therapy. The advantage of the progestin-only treatment is less nausea and vomiting. She does not have contraindications for this therapy such as deep venous thrombosis liver disease or hypertension . Another potential treatment includes the insertion of an intrauterine contraceptive .