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Contraceptive accidents
Failed coitus interruptus
Ejaculation on external genitalia
Miscalculation of rhythm method
Condom rupture, dislodgment or misuse
Diaphragm / Cap inserted incorrectly,
dislodged, found to be torn or removed too
early.
Complete or partial expulsion of IUD.
Mid-cycle IUD removal due to side effects
Missed combined pills
Missed progestin - only pill.
Types of EC
1. Estrogens - 50mg of DES was first tried on a
rape victim (1960).
DES - 25 to 50mg/day for 4-5 days
EE - 2 - 5mg/day for 3-5 days
CE - 30 - 50mg/day for 2-5 days
Side effects - Nausea, vomiting, headache,
dizziness,
breast tenderness, irregular bleeding.
Types of EC - contd
2. Yuzpe method - Canadian Physician tried single dose of
100ugm of estrogen and 1 mg of dl-norgestrel (1970).
2 tabs of EE 50 ugm + LNG 250 ugm stat, to be
repeated after 12 hours.
4 tabs of EE 30 ugm + NG 300 ugm stat,to be
repeated after 12 hrs.
(PC 4, Tetragynon, Fertilan)
Types of EC - contd
3. Only Progestins - Levonorgestrel (0.75 mg) or
Norgestrel (1.5 gm) stat and repeat after 12 hrs.
LNG - Ecee 2 (German Remedies)
Pill 72 (Cipla Ltd)
Norlevo (Win-Medicare)
This method is most commonly used all over the world
today.
Mechanisms of Action 1. Inhibit / Delay ovulation
2. Effect on tubal transport
3. Hamper development of fertilized ovum
4. Prevent implantation in endometrium by making it out of
phase by hormonal imbalance
5. Does not interrupt an established pregnancy
Types of EC - contd
4. Anti Progestogen Mifepristone - 600mg single
dose of RU - 486 - MA - Competes with
progesterone for receptor binding, alters ovarian
follicular maturation, effect on ovulation /
fertilisation / tubal transport / implantation.
5. Danazol - 2 or 3 doses of 400 mg each at 12 hr
interval. MA - Anti-implantation agent.
6. Centchroman - Anti-implantation agent
7. Copper IUD - Inserted within 5 days
MA - prevent fertilization, implantation,
blastotoxic / embryotoxic.
In case of method failure - MTP recommended.
Counselling
Dr Adarsh Bhargava.
Dr Ashwini Bhalerao.
Dr Alka Kriplani.
Dr. Kalpana Apte.
Dr Mala Arora.
Dr.Meenakshi Bharath.
Dr. Mandakini Parihar.
Dr.Nozer Sheriar.
Dr.Parikshit Tank.
Dr. Roza Olyai.
Dr.Sasikala Kola.