APGO Educational Objectives:
- Describe the mechanism of action, degree of effectiveness, advantages and
disadvantages, contraindications, and potential complications for each commonly utilized
method of contraception.
- Describe the advantages and disadvantages, contraindications, and potential
complications for each commonly used method of male and female sterilization.
- Explain the diagnosis and management of the causes of first trimester bleeding,
including incomplete, threatened, and missed abortion, as well as the potential
complications of spontaneous abortion.
Recommended Reading Assignment:
- Contraception, Chapter 25, Sterilization, Chapter 26, pp 297-323, in Obstetrics
and Gynecology, 3rd Edition, Beckmann, et al, pp.
Case #1 Questions:
- Discuss the various forms of contraception available, their effectiveness and
contraindications to their use.
On further questioning Mrs. M.P. states that she had a deep vein
thrombophlebitis and pulmonary embolism during her last pregnancy and that she is
concerned that the form of contraception she uses will make her already heavy menses even
heavier. Her physical exam is normal except that on pelvic exam her uterus is irregular
and approximately 12 weeks gestational size.
- With the above information discuss which forms of contraception are appropriate
for this patient and discuss which forms are contraindicated and why.
After discussing the forms of contraception that are appropriate for her Mrs.
M.P. states she has heard about having her tubes tied and would like to have this done.
- How would you counsel this patient regarding a sterilization procedure?
- Discuss the various procedures for female sterilization.
- Compare female versus male sterilization in terms of:
- Effectiveness
- Possible Complications
- Ease of Procedure
- Cost
Case #2 Questions
- Define the following terms:
- Threatened abortion
- Inevitable abortion
- Incomplete abortion
- Complete abortion
- Missed abortion
- Recurrent abortion
- List possible cause of first and second trimester abortions.
- List possible causes of recurrent abortion.
Mrs. J.R. is extremely upset and wants to know what diagnostic tests can be
performed to assure her there is nothing wrong with her pregnancy.
- What test(s) would you perform?
- If the tests show there is a viable intrauterine pregnancy, how would you treat
this patient?
- If the tests indicate an incomplete abortion, how would you treat this patient?
- Is knowledge of her blood type and RH important?