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World J Obstet Gynecol. Nov 10, 2015; 4(4): 95-101
Published online Nov 10, 2015. doi: 10.5317/wjog.v4.i4.95
Emergency contraception: What is new?
Sefa Kelekci, Serpil Aydogmus
Sefa Kelekci, Serpil Aydogmus, Ataturk Research and Training Hospital, Department of Obstetrics and Gynecology, School of Medicine, Izmir Katip Celebi University, 35150 Izmir, Turkey
Author contributions: Kelekci S and Aydogmus S contrubuted to this paper; Kelekci S also designed the outline and coordinated the writing of the paper.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sefa Kelekci, MD, Ataturk Research and Training Hospital, Department of Obstetrics and Gynecology, School of Medicine, Izmir Katip Celebi University, Polat St., Karabaglar, 35150 Izmir, Turkey. sefakelekci@gmail.com
Telephone: +90-232-2444444
Received: May 11, 2015
Peer-review started: May 18, 2015
First decision: July 10, 2015
Revised: August 14, 2015
Accepted: September 7, 2015
Article in press: September 8, 2015
Published online: November 10, 2015
Abstract

Unintended pregnancy rates remain high throughout the World and increase the risk of poor maternal and infant outcomes. Most of unintended pregnancies occur in women who were not using contraception or who became pregnant despite the reported use of contraception. Women who have had recent unprotected intercourse including those who have had another form of contraception fail are potential candidates for this intervention. Currently used emergency contraceptive methods are pills that contain combined estrogen-progesterone, only progestin, antiprogestins and copper intrauterine devices. The most common form of this type of contraception is oral progestin-only pills (levonorgestrel). The most effective method is copper intrauterine devices followed by anti-progestins and oral progestin-only pills. The major pathogenesis of oral emergency contraceptives is the prevention or delay of ovulation. Although conception is possible on only a few days of the cycle, emergency contraception is offered when indicated without regard to the timing of the menstrual cycle because of uncertainty in the timing of the ovulation. Levonorgestrel and E/P regimes are most effective as soon as possible after unprotected sexual intercourse. A linear relationship has been shown between effectiveness and the time of dose. The effectiveness continues for 120 h, but it is recommended to be used within 72 h after intercourse. Intrauterine devices may prevent pregnancy when 5 d after ovulation.

Keywords: Emergency contraception, Levonorgestrel, Mifepristone, Ovulation, Ulipristal acetate

Core tip: Emergency contraception methods have varying ranges of effectiveness depending on the method and timing of administration. The major pathogenesis of oral emergency contraceptives is the prevention or delay of ovulation or prevention of fertilisation. Combined and progestin-based emergency contraceptives should be used as soon as possible to enhance the efficacy. Emergency contraception offers a final chance to prevent pregnancy.