Assess the following clinical scenarios. For each patient—all of whom have a negative serum beta-hCG today and seek reliable contraception—select the most appropriate and safest method according to the World Health Organization Medical Eligibility Criteria (WHO MEC).
- A 39-year-old woman undergoing active adjunctive therapy for estrogen-receptor-positive breast cancer; she has regular menses and a normal pelvic ultrasound.Copper T380A intrauterine device
- A 26-year-old woman with a known bicornuate uterus and focal epilepsy well-controlled on phenytoin. She desires highly effective contraception but frequently forgets to take daily medications.Depot medroxyprogesterone acetate injection
- A 34-year-old woman who smokes one pack of cigarettes daily and experiences migraine headaches preceded by scintillating scotomata. She reports severe dysmenorrhea and heavy menstrual bleeding.Levonorgestrel-releasing intrauterine device
- A 29-year-old woman who is 14 days postpartum and breastfeeding exclusively. She has chronic hypertension (current blood pressure 148/96 mmHg) and strongly prefers a non-invasive, oral contraceptive option.Norethindrone minipill
Cevap
Match each patient's specific comorbidities and preferences with the contraceptive method that avoids WHO MEC category 3 or 4 contraindications while addressing their secondary symptoms.
Each correct match optimizes contraceptive efficacy while strictly avoiding WHO MEC Category 3 (theoretical or proven risks usually outweigh advantages) and Category 4 (unacceptable health risk) conditions, tailoring the choice to anatomical, metabolic, and systemic constraints.
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Anahtar Kavram
World Health Organization Medical Eligibility Criteria (WHO MEC) for Contraceptive Use