A 17-year-old female presents to your office during walk-in hours on Monday morning. Parental permission has previously been granted to allow her to seek out her own healthcare. She states that she had unprotected sex two nights before. She is concerned about getting pregnant. Vitals are normal. Height is 5’7”, weight is 197 lbs (BMI 31, obesity). In addition to STI screening, you suggest emergency contraception as follows:
Correct!
Wrong!
ANSWER EXPLANATION
Answer – Ulipristal Acetate 30 mg po once.
A) Etonogestrel implantable (Nexplanon) would not provide known effective emergency contraception.
B) Ulipristal (Ella) provides emergency contraception and is not affected by the child’s obesity. There may be access barriers since it is not always carried by all pharmacies.
C) Levonorgestrel (Plan B) may not be effective due to the child’s obesity.
D) Levonorgestrel at this dosing is not appropriate.
E) Copper IUD should be inserted within 1-5 days of first intercourse for effectiveness.
Emergency Contraception / PrEP
Jessica Castonguay, DO, MPH, FAAP
Fall 2020 ACOP Conference
