I would NOT fit Mirena as that is not effective post coitally and you
should advise abstinence for a week before removal or changing Mirenas
in those who are amenorrhoeic. You are in a no win situation, we had a
pregnancy some years ago when we were a little lax and said to people to
book every 3 months for their depots, one lady came by calendar months
so was always a few days late and got pregnant. She had at least 1
injection while pregnant, not my patient so do not know the outcome. can
your patient not take any responsibility for her own actions or is she
under duress? What is really going on here?
Karen
PS Happy New Year in case I do not post for another long time
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