Contraception elligability criteria WHO: Aboubakr Elnashar
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Transcript of Contraception elligability criteria WHO: Aboubakr Elnashar
Understanding and using
WHO Medical Eligibility Criteria for
Contraceptive Use (WHO MEC, 2010)
Prof. Aboubakr Elnashar [email protected]
Objective Understanding and using
Tables
Wheel
Contraceptive Method Choice
1. Safety
2. Effectiveness
3. Availability (accessibility and affordability)
4. Acceptability.
Copper
IUD
Levonor
gestrel
IUD
Implant Injection POP Combined
pill;
Patch
Ring
Based on the current scientific evidence
Category 1: Safe
No restriction for use
Category 2: Usable
Advantages outweigh risks (theoretical or proven):
careful follow-up may be required
Category 3: Not recommended
Risks(theoretical or proven) outweigh advantages
Category 4: No use
Unaccepted health risk
I= Initiation of contraception
C= Continuation of contraception, NA= Not applicable
Breastfeeding: CHC
< 1 month postpartum:
Category 3
>1 month postpartum:
Category 2
DVT & PE: CHC
Acute DVT/PE: Category 4
DVT/PE on anticoagulant
for at least 3 months
Higher risk of recurrence
Thrombophilia
Cancer
Recurrence
: Category 4
Lower risk of recurrence
: Category 3
Bariatric Surgery: CHC
Restrictive procedures:
(gastric band or sleeve):
Category 1
Malabsorptive procedures Malabsorption from method or SE of long term
vomiting/diarrhea
: COCs: Category 3
: P/Ring: Category 1
Hypertension: CHC
Adequately controlled:
Category 3
Elevated BP levels:
S 140-159 OR D 90-99
: Category 3
S > 160 OR D > 100
: Category 4
Vascular disease: Category 4
Hypertension during pregnancy: Category 2
Obesity: CHC
BMI > 30: Category 2
{Possible increased risk
of VTE, MI, stroke}
Rheumatic Diseases: CHC SLE
Positive or unknown
APL antibodies: C4
Thrombocytopenia: C2
Immunosuppression: C2
None of above: C2
Rheumatoid Arthritis
Immunosuppression:
C2
Non-suppressed: C2
Age: CHC
Menarche to <40 years:
Category 1
> 40 years old: Category 2
Smoking: CHC <35 and smoke: 2
>35 and smoke <15/day: 3
>35 and smoke > 15/day: 4
Thank you Aboubakr Elnashar