A 23-year-old woman presents 100 hours after unprotected intercourse. She declines intrauterine device insertion. The MOST appropriate emergency contraceptive option is:

• A Levonorgestrel 1.5 mg single dose
• B Reassurance only, as the fertile window has passed
• C Mifepristone 10 mg single dose
• D Ulipristal acetate 30 mg single dose ✓

Explanation

Ulipristal acetate, a selective progesterone receptor modulator that delays or inhibits ovulation, retains efficacy up to 120 hours after intercourse and outperforms levonorgestrel between 72 and 120 hours. Levonorgestrel is licensed only to 72 hours, so offering it at 100 hours falls outside its evidence base. Low-dose mifepristone is not an approved emergency contraceptive in India. Delaying ovulation is the shared mechanism, but the wider therapeutic window decides this item.

Reference: Williams Gynecology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.