A 19-year-old sexually active woman requests emergency contraception 52 hours after unprotected intercourse. She has no contraindications. The MOST effective oral emergency contraceptive option available is:

• A Ulipristal acetate (UPA) 30 mg, effective up to 120 hours ✓
• B Levonorgestrel 1.5 mg (Plan B) within 72 hours
• C Mifepristone 200 mg within 72 hours
• D Combined estrogen-progestogen Yuzpe regimen

Explanation

Ulipristal acetate (UPA, 30 mg) is more effective than levonorgestrel for emergency contraception, particularly when taken later (up to 120 hours) and in women with higher BMI. UPA acts as a selective progesterone receptor modulator, primarily delaying ovulation. At 52 hours post-coitus, UPA is preferable to LNG. The copper IUD (not listed here) remains the most effective method (>99%). Yuzpe regimen is obsolete due to lower efficacy and higher side effects.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.