A 22-year-old woman is examined 58 hours after an alleged sexual assault. She wishes to prevent pregnancy. The most appropriate immediate step is:
- A Advise her that pharmacological contraception is no longer possible and to return if she misses a period
- B Levonorgestrel 1.5 mg as a single oral dose ✓
- C Mifepristone 200 mg orally
- D Combined oral contraceptive pills daily for 21 days starting today
Correct answer: B. Levonorgestrel 1.5 mg as a single oral dose
Explanation
Levonorgestrel 1.5 mg as a single dose is the standard emergency contraceptive after sexual assault and is effective when taken within 72 hours of the event, so it is still indicated at 58 hours. Declining care is wrong because the window has not closed. Mifepristone is an abortifacient used later in pregnancy, not emergency contraception. B regular 21-day combined pill course provides no post-coital protection and is not the regimen used for this purpose.
Reference: Parikh's Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.