EBCOG Part 1-Postnatal Care & Sexual Reproductive Health-Day 6 (SBA)

You see a 35-year-old para 3 in your outpatient hysteroscopy clinic. She wants to be sterilized and undergoes hysteroscopic sterilization using the Essure device. What post procedure advice will you offer her?

A. Backup contraceptive cover for 3 months
B. Backup contraceptive cover for 1 month.
C. Backup contraceptive cover is unnecessary.
D. Tubal occlusion should be confirmed in 6 weeks.
E. Tubal occlusion confirmatory test is unnecessary.

2. A hysteroscopic tubal sterilization using flexible microinserts (Essure) is performed. The procedure time is about 30 minutes (from insertion to removal of hysteroscope), and there was a concern regarding possible perforation due to a sudden loss of resistance at insertion. What is the suggested method of confirming that the procedure has been successful?

A. Hysterosalpingogram
B. Magnetic resonance imaging
C. Transvaginal ultrasound scan
D. Pelvic x-ray.
E. Diagnostic laparoscopy

3. Ms. XY is 35 years old. She is a Para 3 with two previous caesarean sections and desires permanent contraception. She has opted to have a laparoscopic tubal occlu- sion/sterilisation procedure. Her BMI is 33. She has had two failed attempts at Veress needle insertion through the umbilical route. Which of the following treatment options are best suited to her?

A. Abandon the procedure.
B. Direct trocar insertion.
C. Hysteroscopic Essure sterilisation (also permanent).
D. Palmer’s point entry
E. Third attempt by a different operator.

4. Vasectomy failure rate is quoted as approximately 1 in 2000 (0.05%) after clearance has been given. By how many months postprocedure should the vasectomy be considered a failure if motile sperm are still observed in a fresh semen sample?

A. 3 months
B. 4 months
C. 5 months
D. 6 months
E. 7 months

5. Your consultant has successfully carried out a hysteroscopic tubal occlusion (Essure ESS305 microinsert. © Bayer). You are asked to review the patient before discharge. What is the most important advice to give the patient prior to discharge?

A. She should come for a review after her next period.
B. She should seek medical advice if she misses her next period.
C. She should come for an X-ray after her next period to confirm proper placement of the occlusion device.
D. She should avoid intercourse until she has her next period.
E. She should use a reliable method of contraception for three months and until proper placement of the device is confirmed.

6. Which of the following statements is appropriate for contraceptive advice to women with inflammatory bowel disease?

A. Condoms are the preferred method in women who are on medication for IBD as its efficacy cannot be affected by them
B. Laparoscopic sterilisation is an appropriate method of contraception for women with IBD who have had previous pelvic or abdominal surgery
C. Women can be informed that there is a causal association between combined oral contraception (COC) use and onset or exacerbation of IBD so it is best avoided.
D. Women should be advised that the efficacy of oral contraception is unlikely to be reduced by large bowel disease but may be reduced in women with Crohn’s disease who have small bowel disease and malabsorption
E. Women using combined hormonal contraception do not need any additional contraception while taking antibiotic courses.

7. A 28-year-old woman consults you about combined hormonal contraception (CHC). Her mother died of breast cancer at the age of 55 years. She is healthy but has a problem with painful periods. Use of CHC in this condition full fills which UKMEC category?

A. 1
B. 2
C. 3
D. 4
E. 5

8. Mrs XY is a 35-year-old woman who is a known case of congenital heart disease with a single ventricular physiology and on regular follow-up with the cardiologist. She is stable in regard to her cardiac condition and wants an intrauterine contracep- tive device (IUCD) inserted. Her cardiologist has given his consent for the same after reviewing her case. Based on our knowledge of the UKMEC, She fulfils which medical eligibility criteria for use of IUCD in this condition?

A. 1
B. 2
C. 3
D. 4
E. 5

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EBCOG Part 1-Postnatal Care & Sexual Reproductive Health-Day 6 (SBA)

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