O&G

• Fitz-Hugh-Curtis syndrome ( typical violin string appearance)
• Adhesion b/w liver & peritoneal surface

• 1. Uncontrolled HPT, DM, obese
• 2. Migraine w aura
• 3. Hx of VTE
• 4. > 35 y/o smokes > 15 cigs/day
• 5. Major surgery w prolonged immobility
• 6. Vascular dz / stroke
• 7. IHD, Cardiomyopathy, Afib
• 8. Liver cirrhosis & tumors
• 9. SLE & APL

Number of contraceptive failure per 100 women years of exposure

- failure rate of contraception / used to summarize contraceptive effectiveness

- smaller the PI, the safer the method of contraception

• From safest > not safest
• - Subdermal implant
• - Male sterile
• - Mirena
• - Female sterile
• - Copper IUD
• - POP injx
• - POP
• - Male condom

• Missed 1 pill
• - take missed pill as soon as pt remembers followed by her regularly scheduled pill

• Missed 2 or more consecutive pills
• - remaining pills taken at usual time & backup contraception (ex: condom)
• - if missed in 1st week of cycle & unprotected sex - need emergency contraceptive

• Missed pill in 3rd week of active pills
• - finish that last week of hormone pills (week 3). Skip placebo pills. Immediately move to new pill pack the next day after finish week 3 hormonal pills

• Abdomen
• Upper outer arm
• Upper back (blkg bahu, not breast)
• Buttocks

• Diff side used each time
• Patch changed once/week for 3 weeks followed by 1 patch-free week

• Foreign body effect
• 1. Uterus exposed to foreign body by the IUD frame
• 2. Sterile inflammation occur
• 3. This is toxic to sperm & ova
• 4. Impair implantation

+ local changes caused by released meds

Calender based method - avoid unprotected SI D8-D19

BBT, ovulation method - wait until 3 days after

Transdermal combined patch - for 3 weeks (change once/week), 1 week patch free

Vaginal ring - left 3 weeks

Progestin injectables - last 12 weeks/3 months

Subdermal implant - 3 years

IUD (Mirena) - 5 yrs, copper (10 yrs)

EC - LNG (w/in 1st 3 days), IUD & UPA (w/in 5 days)

• Labetalol
• Nifedipine
• Methyldopa

• At least 2/3:
• 1) Polycystic ovaries (12 or more follicles/incteased ovarian volume)
• 2) Oligomenorrhea/Amenorrhea
• 3) Clinical/Biochemical signs of hyperandrogenism
• - clinical: acne, hirsutism
• - biochemical: raised serum testosterone

1. COCP - to regulate menses and prevent endometrial hyperplasia from unopposed estrogen

• 2. Clomiphene citrate (Clomid)
• Anti-estrogenic effect (inhibit estrogen -ve feedback) cause increase GnRH and FSH for follicular growth so that ovulation can occur

3. Metformin - glucose intolerance

• HOSARA
• 1. Hirsutism
• 2. Obese
• 3. Subfertility
• 4. Acne
• 5. Recurrent miscarriage
• 6. Acanthosis nigricans

• Aka intrauterine adhesion
• Common complication of dilation & curretage

• Aka mullerian agenesis
• Absence of uterus, vagina or both. Ovaries preserve unlike in androgen insensitivity syndrome (AIS) - girl but genetically male who is resistant to male hormone who has no uterus, ovaries but has breast & pubic hair