A 32-year-old woman requests emergency contraception (EC) 60 hours after unprotected intercourse. She has a BMI of 32 kg/m². The MOST effective non-surgical EC option at this time-point is:

• A Levonorgestrel 1.5 mg
• B Combined estrogen-progestogen (Yuzpe method)
• C Mifepristone 200 mg
• D Ulipristal acetate (UPA) 30 mg ✓

Explanation

Ulipristal acetate (UPA, ellaOne 30 mg) is licensed for EC up to 120 hours (5 days) after unprotected intercourse and maintains efficacy throughout this window with superior effectiveness compared to levonorgestrel, especially between 72–120 hours. In women with BMI >26 kg/m², levonorgestrel is known to have significantly reduced efficacy, whereas UPA is less affected by weight (though the Cu-IUD remains most effective for all BMI categories). The Yuzpe method is inferior to both.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.