Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
21 Cards in this Set
- Front
- Back
What is the proportion of unintended pregnancies in the US? How many of these are aborted?
|
Half of all pregnancies are unintended, and almost half of these are aborted. In teens, 78 % of pregnancies are unintended, and half are aborted.
|
|
What's the difference between method-effectiveness and use-effectiveness?
|
method-effectiveness: correct (ideal) (supervised? how do you get that job?) use of the contraceptive
use-effectiveness: normal unsupervised use of contraceptives |
|
What are the method and use failure rates for the pill, IUD, Condoms, Depo, and sterilization?
|
Pill: method: 0.1%, use: 3 %
IUD: 0.1 %, 0.1 % Condoms: 3 %, 14 % Depo: 0.3 %, 0.3 % Male sterilization: 0.1 %, 0.1 % Female sterilization: 0.05 % |
|
What are the method and use failure rates for no method, the diaphragm, rhythm, and withdrawal?
|
No method: method: 85%, use: 85%
Diaphragm: 6 %, 20 % Rhythm: 9 %, 25 % Withdrawal: 4 %, 19 % (All more than 15 % use failure rate) |
|
What's the most common contraceptive used by women from 15-29 years old? What about women 40-44 years old?
|
15-29 yo: 36 % on the pill, ~25 % condoms
40-44 yo: 47 % sterilized, 20% sterilized partners |
|
What are the methods of hormonal contraception talked about in the previous lecture?
|
Oral contraceptives, NuvaRing, OrthoEvra (patch), Depo-Provera (IM, progestin-only), Emergency contraception
|
|
How do IUDs work?
|
They provoke a sterile inflammatory response in the endometrium, which is toxic to sperm and blastocysts. They also decrease tubal motility and have adverse effects on cervical mucus
|
|
What are the advantages and side effects of an IUD?
|
adv: needs no action at time of coitus, reduced blood lost during menses (if with progestins)
AE: dysmenorrhea, menorrhagia, intermenstrual bleeding, expulsion, uterine perforation (1/1000), low incidence of pregnancy (but often ectopic), PID (less now) |
|
What is the difference between the two types of IUD available?
|
Copper-T: no hormones, lasts 10 years
Levonorgestrel-IUD (Mirena): releases levonorgestrel, lasts 5 years, suppreses endometrium (progestin). adv: protects from endometrial hyperplasia, reduced endometrial cancer, less progestin than progestin-only pill, amenorrhea in 20%. |
|
What are the contraindications to IUD use?
|
uterine anomalies, blood dyscrasias, undiagnosed uterine bleeding, acute PID (or hx + risk factors), untreated acute vaginitis or cervicitis, pregnancy, carcinoma of cervix or endometrium, Wilson's disease (copper allergy), multiple sex partners, deficient immunity, genital actinomycosis
|
|
How does a male condom work?
|
Barrier method.
~80% efficacy (3-14% failure rate). adv: inexpensive, no hormones, protects from STIs, best w/ spermicide. disadv: use every time, latex |
|
How does a female condom work?
|
Barrier method.
~80% efficacy (5-25% failure rate). adv: inexpensive, no hormones, STI protection, used by female, best with spermicide. disadv: use every time, discomfort, latex. |
|
How does a diaphragm work?
|
Barrier method.
Fill with spermicide and insert before each coitus, leave in vagina at least 6 hrs post-intercourse, then remove, wash and reuse. ~80% effective (6-20% failure rate) adv: used by female, no hormones, protects from STIs, private. disadv: use every time, needs fitting by doc, replace every year, refit after wt gain or loss |
|
How does spermicide work?
|
disrupts the sperm cell membrane and affects motility. ~80% efficacy.
adv: many delivery systems, nonoxynol-9 kill HIV, inexpensive, no prescription, combine with barrier method. disadv: use every time, cytotoxic effect on vaginal mucosa (irritiation --> increased risk for STIs if used alone) |
|
How does the rhythm method (fertility awareness) work?
|
Effective when used correctly, 25 % of women get pregnant w/in a year. Must be very committed.
Methods: calendar method, basal body temperature, cervical mucus testing, symptothermal method (2 or more, usually BBT and cervical mucus) adv: no side affects, acceptable by all, low cost |
|
What is female sterilization?
|
surpical partial slapingectomy, tubal electrocautery or application of clips/elastic rings. Usually laparoscopic or immediately post-partum. Considered major surgery.
up to 10% of women regret it. Failure rate: 0.5 %, up to 5 %, and many of these are ectopic. |
|
What is male sterilization?
|
vasectomy, surpical occlusion of the vas deferens, under local anesthesia. Much safer than for females.
AE: local hematoma. Rarely reversible. Less expensive than tubal ligation. |
|
How are most early abortions done in the US?
|
vacuum aspiration aka dilation and evacuation (D&E). local/gen anesthesia, dilate cervix, insert suction curette, empty uterus.
|
|
How is a medical abortion performed?
|
Mifepristone then misoprostol, or methotrexate then misoprostol. Practitioners must be able to perform a D&E in case this fails. 96 % efficacy.
|
|
How are second-trimester abortions performed?
|
Dilation and evacuation or induction of labor to deliver a nonviable fetus. Misoprostol can help in dilating the cervix.
|
|
What are the complications for therapeutic abortions and what is the rate?
|
1/200 cases (lower than pregnancy and most other elective surgery).
risk increases with gestational age and comorbidities. AEs: anesthesia-related problems, infection, intrauterine blood clots, incomplete abortion, continuing pregnancy, cervical/uterine trauma, hemorrhage. Impaired fertility and psychological trauma are rare. |