The 'Medical Eligibility Criteria' (MEC) for contraceptive use, developed by WHO and adopted in India, classifies conditions into four categories. A woman with compensated cirrhosis of liver (Child-Pugh A) who wants to use Combined Oral Contraceptives (COCs) would fall under which MEC category?

• A MEC 3 — risks generally outweigh advantages ✓
• B MEC 1 — no restriction, method can be used
• C MEC 2 — advantages generally outweigh risks
• D MEC 4 — absolute contraindication, method must not be used

Explanation

WHO MEC classification: MEC 1 = no restriction; MEC 2 = advantages outweigh theoretical risks; MEC 3 = risks generally outweigh advantages (use only when more appropriate methods unavailable or unacceptable); MEC 4 = unacceptable health risk (absolute contraindication). Mild compensated cirrhosis (Child-Pugh A) with COCs = MEC 3, as COCs are hepatically metabolized and can worsen hepatic function. Decompensated cirrhosis = MEC 4. Severe cirrhosis with COCs is MEC 4. Progestogen-only pills are MEC 3 for mild cirrhosis. This distinction between Child-Pugh A (MEC 3) and decompensated (MEC 4) is frequently tested.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.