Obstetrics and Gynecology - A. M. Hromova 2000

Modern family planning methods
Modern methods of contraception
Emergency (postcoital) contraception

Postcoital Contraception can be used in cases of unprotected intercourse when Pregnancy is unplanned, though it should not be relied upon as a primary, regular method of contraception.

The efficacy of these Methods reaches up to 96% if unprotected intercourse occurred no more than 72 hours ago. Postcoital contraception may involve The Use of monophasic COCs, progestogens, mifepristone, or IUDs.

Emergency contraception with COCs is administered using the Yuzpe regimen: 4 low-dose COC tablets (containing 30 mcg of ethinyl estradiol) are taken within the first 72 hours after unprotected intercourse, followed by a second dose of 4 tablets 12 hours later. Alternatively, when using high-dose COCs (50 mcg of ethinyl estradiol), 2 tablets are taken within the first 72 hours, with another dose of 2 tablets repeated 12 hours later.

Danazol, acting as a steroidogenesis blocker in the corpus luteum and an antigonadotropic agent, is used for emergency contraception in two regimens:

- 200 mg daily for 5 days;

- 400–600 mg twice within 24 hours.

Postcoital contraceptives also include agents designed to disrupt implantation, such as anordin (7.5 mg) and centchroman (60 mg).

Insertion of an IUD for postcoital contraception must be performed no later than 5 days after unprotected intercourse and provides a contraceptive efficacy of nearly 99%.

In the event of a menstrual delay of 7–10 days, menstruation can be induced using mifepristone, an endogenous progesterone blocker (100 to 600 mg daily for 7 days), or epostane, a progesterone synthesis inhibitor (200 mg 4 times a day for 4–5 days). Pregnancy termination is initiated by bleeding in 73–94% of women and results in complete abortion.

For postcoital contraception in the form of gels, aerosols, or suppositories, ensaprost-F, prostial, or gemeprost are used at a dose of 10–15 mg once daily. The effectiveness of this approach ranges from 70 to 80%, with virtually no adverse reactions or contraindications.

If menstruation is delayed by more than three weeks following the use of any postcoital contraception method, the patient must consult a physician to rule out pregnancy.