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Multiple UPSI episodes — DFSRH MCQ

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HardEmergency contraceptionMultiple UPSI episodesDFSRH

A woman had UPSI 8 days ago and again 2 days ago in the same cycle. She declines a copper IUD and cannot establish ovulation timing. What should oral-EC counselling make explicit?

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Correct answer: D — Offer oral EC for the recent UPSI and arrange timed pregnancy testing

The best answer is “Offer oral EC for the recent UPSI and arrange timed pregnancy testing”. Oral emergency contraception can be offered for the UPSI 2 days ago, but it does not disrupt an established pregnancy and cannot retrospectively guarantee protection from the episode 8 days ago. A pregnancy test today is too early to exclude either conception. Counselling must include a pregnancy test 3 weeks after the latest UPSI, urgent review for symptoms and an ongoing-method plan.

Reference: CoSRH/FSRH, Emergency Contraception (amended July 2023): https://www.cosrh.org/Common/Uploaded%20files/documents/fsrh-guideline-emergency-contraception03dec2020-amendedjuly2023-11jul.pdf