management A pregnancy test must be performed and negative prior to administration It is offered within 120 hours of an assault with vaginal penetration or genital contact with ejaculation occurred Progestin-only emergency contraceptive pills are most favorable in terms of safety, adverse effects, and efficacy A total of 1.5 mg of levonorgestrel can be taken once, with or without ondansetron to mitigate nausea and/or vomiting Emergency contraception is up to 90% effective in pregnancy prevention No studies to date show untoward effects on the fetus should pregnancy occur; it does not disrupt an already implanted pregnancy Pregnancy testing should be repeated at weeks Reporting Physicians and other healthcare professionals are mandated reporters under U.S law, and therefore, are required to report suspected as well as known cases of child abuse ( Table 127.6 ) In many states, the suspicion of child sexual abuse as a possible diagnosis requires a report to both the appropriate law enforcement and CPS agencies For many children who present with complaints of sexual assault, CPS and the police may have already been involved; however, some children present prior to contact with these agencies Medical providers need to be aware of their mandated reporter status and the associated obligation to report any suspicions of child abuse The threshold for reporting is low; if there is a reasonable suspicion of sexual abuse, a report is indicated The CPS agency then has the responsibility to conduct a thorough investigation to determine whether the abuse has occurred Mandated reporters are protected against criminal or civil repercussions for any report made in good faith, no matter the eventual outcome of that investigation