Contraception for Women with Medical Problems

Abstract

Summary: Women with medical disease have a higher incidence of maternal mortality compared with healthy women, with cardiac disease now being the most common cause of maternal death in the UK. A handful of medical conditions exist where pregnancy is not recommended due to mortality rates approaching 50%. It is imperative that such women have the most reliable methods of contraception available. Contraceptive agents may themselves affect medical disease, or may interact with medications used by such women. There may be a range of contraceptive agents suitable for each medical condition. The contraceptive selected should be tailored to suit the individual. The following points should be considered when deciding on the most appropriate contraceptive agent: efficacy, thrombotic risk (oestrogen containing contraceptives), arterial risks (oestrogen containing contraceptives), infective risk (e.g. insertion of intrauterine device [IUD]), vagal stimulation (e.g. insertion of IUD, ESSURE w ), bleeding risks with patients on anticoagulants, interaction with concomitant drugs, effects of anaesthesia and ease of use. This review aims to cover the different contraceptive agents available and the best ones to use for certain medical illnesses.

Hormonal therapy in women, thromboembolic complications and laboratory characteristics of the hemostasis system for personalized solutions

“…В нашем случае тромбофилии умеренного риска (мутация фактора V (Лейденская мутация); мутация фактора II G20210A) встретились у 26 % женщин, имевших ТЭО на фоне ГТ.Длительность применения препарата в сочетании с другими факторами также связана с риском развития тромбоза. По данным некоторых авторов, в группе женщин моложе 30 лет наиболее высокий риск тромбоза наблюдался в течение первого года применения ГТ, с последующим его снижением[5]. В группе женщин старше 30 лет, а также у пациенток с тромбофилией снижения риска при длитель-Рис.…”