A 22-year-old woman presents requesting emergency contraception 72 hours after unprotected intercourse. She is breastfeeding an 8-week-old infant. Which emergency contraceptive is MOST appropriate?

• A Levonorgestrel 1.5 mg orally ✓
• B Ulipristal acetate 30 mg orally
• C Combined oral contraceptive pill (Yuzpe method)
• D Copper-releasing intrauterine device insertion

Explanation

Levonorgestrel emergency contraception (1.5 mg) is the preferred oral option in breastfeeding women; it is safe during lactation with minimal transfer to breast milk. Ulipristal acetate (UPA) is contraindicated or requires pump-and-discard for 1 week due to its anti-progesterone activity and potential passage to the infant. The Yuzpe method (oestrogen-containing) is generally avoided in breastfeeding. Copper IUD is the most effective option but involves a procedure; levonorgestrel is the most practical oral choice within 72 hours.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.