UPDATE
Types of Infections: Postpartum
- CORRECT ANSWER • End metritis (metritis): infection of the uterine lining that can
extend too varies, fallopian tubes, pelvic thrombophlebitis. Can occur up to 6weeks after
delivery
• Wound infections: cesarean incision site, episiotomy, perineal or genital tract
laceration.
• UTI: catheterization, trauma from delivery
• Mastitis: inflammation of the breast tissue
Methods of Contraception
- CORRECT ANSWER Reversible:
-Behavior: natural family planning, abstinence
-Barrier: condoms, etc.
-Hormonal
Permanent:
-Tubal ligation
-Vasectomy
Contraceptive: Diaphragm
- CORRECT ANSWER -Insert up to 4 hours before with spermicide
-Keep in for 6 hours
-Fitted by provider
-May need to be refitted after pregnancy, weight gain or loss 10 lbs., or other pelvic
surgery
Contraceptive: Cervical Cap
- CORRECT ANSWER -Smaller than diaphragm
-Held in place by suction
-Used with spermicide
-Inserted up to 36 hours before & remain in place up to 48 hours
-Fecal only device available in US
-Silicone
-Must be prescribed by provider
-Should not be used during menstruation
Pros & Cons of Barrier Contraceptives
- CORRECT ANSWER See Photo...
Combined Oral Contraception (COC)
, - CORRECT ANSWER -Estrogen & progesterone
-21-day pack: take for 21 days, no pills for 7 days
-28-day pack: take every day
-90-day pack: take 84 days, no pill or sugar pill last 6 day
365-day pack: daily
-All take same time each day
Avoid These Medications w/ COC
- CORRECT ANSWER -Antibiotics
-Anticonvulsant
-Antifungals
-Antiretroviral
-HIV Meds
-Antidepressants/ Antianxiety
-Antiemetic’s
-St. John's Worth
-Pulmonary Arterial
-HTN Meds
Pros and Cons of Oral Contraceptives
- CORRECT ANSWER See Photo...
-Biggest Cons: *CV accidents, headaches, MI, thrombophlebitis, PE*
S/S of serious complication of birth control pills
- CORRECT ANSWER See Photo...
Oral Contraceptive: POP - Progestin Only (Mini Pill)
- CORRECT ANSWER -NO Estrogen
-Thickens cervical mucus
-Thins uterine lining
-Suppresses ovulation (not consistently)
-Used if hex of clots
-Good if breastfeeding (estrogen reduces breast milk production)
-Concerns about taking estrogen
If forget to take your OCO? - CORRECT ANSWER -If you just missed one, take it as
soon as you remember. If you don't remember until the next day, go ahead and take 2
pills that day
-If you forget to take your pills for 2 days, take 2 pills the day you remember and 2 pills
the next day.
-You will then be back on schedule.
-If you miss more than 2 pills, call your provider for instructions
Injectable - Depo Provera - CORRECT ANSWER -Med Roxy progesterone
-Sub-Q or IM (arm or buttock)
, -Every 12 weeks
-Suppress ovulation
-Increases cervical mucus
-Thins lining of uterus
-May reduce bone mass density: take vitamin D
Contraceptive: Implantable-Nexplanon
- CORRECT ANSWER -LARC - long-acting reversible contraceptive
-Small plastic rod inserted under skin of upper arm
-Lasts 3 years
-Slow release etonogestrel (synthetic progesterone)
-Teens to adult
-Irregular cycles
-No protection STIs
Transdermal Contraceptive Patch
- CORRECT ANSWER -Once per week for 3 weeks
-One week off
-More estrogen than COC - HIGHER RISK OF CLOTS
-Avoid submersion in water for more than 30 minutes
-Does not protect against STIs
-Do not put on breast: increased risk of estrogen sensitive BC
-Not if over 198 lbs
Vaginal Insert - NuvaRing
- CORRECT ANSWER -CHC: combined hormonal contraceptive: Estrogen &
progesterone
-Flexible, soft, transparent
-Inserted into vagina for 3 weeks, out for 1 week, repeat with new ring
-Does not protect against STIs
Intrauterine Device (IUD)
- CORRECT ANSWER -Inserted by provider under moderate sedations
-Two Types: Copper & Hormonal
-Over 99% effective; can remain in place for many years (3-10)
IUD Complications
- CORRECT ANSWER See Photo...
Emergency Contraception
- CORRECT ANSWER -Used after unprotected intercourse
-Plan B (progesterone only) used up to 72 hours after sex
-Next Choice - 1 or 2 pills up to 72 hours
-Ella - one pill up to 5 days
-Para Gard IUD inserted up to 5 days after sex