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DRCOG MCQs for Circuit C Questions
Published in Una F. Coales, DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips, 2020
Ovarian carcinoma:Stage III is defined as growth involving one or both ovaries with widespread intraperitoneal metastases.Combined oral contraceptive pill is protective.Spreads haematogenously.Has a higher mortality rate than cervical cancer due to its late presentation.In the management of ovarian carcinoma, surgery is generally followed by chemotherapy.
Neurological problems
Published in Catherine Nelson-Piercy, Handbook of Obstetric Medicine, 2020
Women taking hepatic enzyme-inducing drugs (phenytoin, primidone, carbamazepine, phenobarbitone) require higher doses of oestrogen to achieve adequate contraception. They should be given a combined oral contraceptive pill containing 50 μg ethinyl oestradiol or be instructed to take two pills containing 30 μg. The combined oral contraceptive pill may still not be effective and an alternative method of contraception may be appropriate.
Combined methods
Published in Suzanne Everett, Handbook of Contraception and Sexual Health, 2020
The combined oral contraceptive pill contains the hormones oestrogen and progestogen. The synthetic forms of these found in combined contraceptive methods are ethinylestradiol and progestogens in the form of gestodene, desogestrel, drospirenone, levonorgestrel and norethisterone.
Pregnancy in women with congenital heart disease: a focus on management and preventing the risk of complications
Published in Expert Review of Cardiovascular Therapy, 2023
Gurleen Wander, Johanna A. van der Zande, Roshni R Patel, Mark R Johnson, Jolien Roos-Hesselink
Having effective contraception is essential to allow for the optimization of the clinical state, change in medication and preparation for pregnancy. The combined oral contraceptive pill (OCP), containing both estrogen and progesterone, increases the risk of VTE and is known to increase BP and hence not recommended in patients with preexisting heart disease or hypertension. Progesterone only pills (POP) are safe and frequently used in patients with CHD, particularly the higher dose (Desogestrel 75 mg), which is more reliable as it inhibits ovulation. Long-acting reversible contraceptive methods including Levonorgestrel (LNG) based long-acting implants or intra uterine devices (IUD) are the safest and most effective contraceptives. They offer other non-contraceptive benefits like reduction of heavy menstrual bleeding, iron deficiency anemia, pelvic pain (especially in women with endometriosis), and prevention of endometrial hyperplasia. Infective endocarditis prophylaxis is not needed for insertion of these devices. However, IUD insertion may cause a vasovagal reaction, and this may need to be performed in a hospital setting, especially for Fontan and Eisenmenger syndrome patients [34,35]. Barrier contraceptives are unreliable but prevent sexually transmitted infections. A combination of barrier contraception and LNG IUD is considered to be ideal. For emergency contraception, copper IUD, LNG, or ulipristal acetate (UPA) are safe with no increased risk of thrombosis.
Management of pulmonary arterial hypertension during pregnancy
Published in Expert Review of Respiratory Medicine, 2023
Kaushiga Krishnathasan, Andrew Constantine, Isma Rafiq, Ana Barradas Pires, Hannah Douglas, Laura C Price, Konstantinos Dimopoulos
Several contraceptive options are available, and collaborative decision-making should be based on patient preference and clinical efficacy and safety profiles. Oral contraceptives include the combined pill and the progesterone-only pill. The latter is preferred due to the greater risk of venous and arterial thromboembolism associated with estrogen in the combined oral contraceptive pill. Progesterone is also available as a subcutaneous implant, inserted under local anesthesia [1,7,48]. Intrauterine devices such as copper and levonorgestrel-coated coils are available. Insertion of such devices is associated with a small risk of a vasovagal response, which can be pronounced in patients with PAH and therefore insertion is usually arranged in a hospital setting [3]. Barrier contraception, such as condoms and diaphragms, can protect from sexually transmitted disease but are not considered reliable forms of contraception in PAH due to contraceptive failure rates and the risk of unplanned pregnancy [1,7].
The effect of COVID-19 infection on the menstrual cycle: a cross-sectional investigation in the MENA region
Published in Human Fertility, 2023
Mohammad A. Alshrouf, Abdulrahman M. Karam, Muayad I. Azzam, Majed W. Al-Nazer, Minolia A. Al-Kubaisy, Abdallah Al-Ani, Nadia Muhaidat
A total of 499 women participated in this study. Their ages ranged from 15 to 54 years. The overall mean age of the women was 35.2 ± 8.4 years, and the median was 36 years. The majority of women (61.5%) were between the ages of 30 and 45. Most women (64.5%) were married, and most lived in Jordan (74.5%), the United Arab Emirates (10.4%), and Saudi Arabia (3.2%). Table 1 demonstrates the demographic and clinical characteristics of the participants. Among the participants, 74.1% had regular periods in the past year, and 25.9% had irregular periods. The mean menstrual bleeding was 6.1 ± 1.6 days, and the mean menstrual length was 26.9 ± 5.4. Approximately one-third of the participants (26.7%) were smokers. The majority of participants (81.6%) were disease-free, and only 9% had a history of coagulation disorders (including bleeding, thromboembolism, thrombocytopenia, or taking anticoagulant medication). In addition, 23% of participants reported a history of asthma, allergy to medication, or food allergy. Over the last year, 19% of the participants began using a contraceptive, predominantly the combined oral contraceptive pill (COCP) (8.2%). Moreover, 7% of women discontinued using a contraceptive within the last calendar year, with COCP (4.4%) being the most frequently used (Table 1).