Pregnancy

(Chapter 5, pg. 49)

Rule out the possibility of pregnancy when evaluating the pubertal or postpubertal girl. If serum pregnancy test is negative and the adolescent has a history of unprotected, mid-cycle intercourse that has occurred in the past 72 hours, offer postcoital contraception. Two tablets of ethinyl estradiol 0.05 mg with norgestrel 0.5 mg (OVRAL) can be given at the time of the exam with instruction to repeat the dose in 12 hours.

Explain the action, side effects, failure rate of postcoital contraception, and the need to repeat a pregnancy test at a follow-up visit. Document discussion. If a pregnancy is diagnosed, refer the adolescent for counseling about her options as soon as possible.

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