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Vomiting after oral EC — DFSRH MCQ

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HardEmergency contraceptionVomiting after oral ECDFSRH

A 25-year-old vomits 1 hour after levonorgestrel EC taken 36 hours after UPSI. She is now able to retain fluids, declines a copper IUD and takes no interacting medicine. What should be done next?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Repeat levonorgestrel now and test for pregnancy 3 weeks after UPSI

The best answer is “Repeat levonorgestrel now and test for pregnancy 3 weeks after UPSI”. Vomiting within 3 hours may prevent adequate levonorgestrel absorption, so the dose should be repeated promptly once vomiting has settled. A same-day pregnancy test cannot exclude pregnancy from this UPSI, and starting ongoing contraception does not replace EC. Follow-up should include contraception planning and a pregnancy test 3 weeks after the latest UPSI.

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