Contraception CKD Teratogenic Medications — ESENeph MCQ

Correct answer: B — Consider progestogen contraception or an intrauterine method after eligibility review

The best answer is “Consider progestogen contraception or an intrauterine method after eligibility review”. UKMEC selection considers CKD severity, proteinuria, hypertension, thrombosis, bone health and medicines; long-acting reversible options often provide effective contraception without oestrogen risk. “Use a combined oestrogen pill after specialist thrombosis-risk assessment” is less appropriate because oestrogen can be contraindicated when thrombotic and cardiovascular risk is high “Discuss fertility and contraception despite reduced fertility in advanced CKD” is less appropriate because fertility is variable and pregnancy exposure to ramipril must be prevented “Use barrier contraception when it best matches the patient’s informed preference” is less appropriate because several progestogen-only and intrauterine methods remain suitable “Arrange urgent pregnancy review if ramipril exposure occurs after conception” is less appropriate because RAS blockade requires immediate specialist medication review in pregnancy

Reference: FSRH UK medical eligibility criteria for contraceptive use: https://www.fsrh.org/standards-and-guidance/fsrh-guideline-ukmec/