Which of the following can be used for Post coital contraception?

1. IUD insertion within 5 days
2. OCP within 72 hours
3. Intake of Mifepristone 10 mg within 72 hours

Choose the appropriate answer from the options given below

1. A

   Only 1 and 2

2. B

   Only 2 and 3

3. C

   Only 1 and 3

4. D

   Only 1, 2 and 3

Appeared in: Raj. CHO -2024

Explanation

• All three options listed are valid methods for post-coital (emergency) contraception.
• A Copper IUD is the most effective method and can be inserted up to 5 days after unprotected intercourse.
• Oral contraceptive pills (like Levonorgestrel) are effective, especially when initiated within 72 hours.
• Mifepristone, a progesterone receptor modulator, is another highly effective oral method that can be used within 120 hours.

Why Other Options Were Wrong

• Option A: This option is incomplete. It correctly includes IUD insertion and OCPs but incorrectly omits Mifepristone, which is also a valid method of post-coital contraception.
• Option B: This option is incomplete. It correctly includes OCPs and Mifepristone but incorrectly omits the Copper IUD, which is the most effective method of emergency contraception.
• Option C: This option is incomplete. It correctly includes IUD insertion and Mifepristone but incorrectly omits OCPs (e.g., Levonorgestrel), which are a widely used method of emergency contraception.

Related Visual

• Visual 1: Chart - A comparative chart showing different emergency contraception methods, their timeframes for use, effectiveness rates, and common side effects. This helps in quick recall and comparison.

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Methods of Emergency Contraception as background academic context rather than a clinical decision trigger.
• A nurse's primary role is to provide accurate, non-judgmental counseling about all available EC options, including their effectiveness, side effects, and correct usage.
• It is crucial to emphasize that EC does not protect against sexually transmitted infections (STIs), and counseling on barrier methods should be included.
• Nurses should assess the time since unprotected intercourse to guide the patient toward the most effective method available to them.

How to Approach the Question

• First, read the question to identify the core topic: post-coital (emergency) contraception.
• Evaluate each of the three numbered statements individually based on your knowledge of contraceptive methods.
• Statement 1: Recall the timeframe for Copper IUD as emergency contraception. It is effective up to 5 days (120 hours). So, statement 1 is correct.
• Statement 2: Recall the timeframe for hormonal OCPs. The standard recommendation is within 72 hours for best efficacy. So, statement 2 is correct.
• Statement 3: Recall the use of Mifepristone. It is an effective EC method. The 72-hour window is valid. So, statement 3 is correct.
• Since all three statements are correct, look for the option that includes '1, 2 and 3'.

Concept Tested & Keywords

• Concept Tested: Methods of Emergency Contraception
• Stem keywords: Post coital contraception, IUD insertion, OCP, Mifepristone
• Lead-in keywords: Which of the following, Choose the appropriate answer

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