scholarly journals Risks of venous thromboembolic complications in related to combined oral contraceptives

2022 ◽  
Vol 15 (6) ◽  
pp. 777-787
Author(s):  
K. A. Gabelova ◽  
N. A. Shabanova ◽  
V. F. Bezhenar ◽  
E. E. Zvartau ◽  
Yu. A. Akishina
Keyword(s):  
Oral Contraceptives ◽  
Unwanted Pregnancy ◽  
Hormonal Contraception ◽  
Vena Cava ◽  
Thromboembolic Complications ◽  
Combined Oral Contraceptives ◽  
Increased Risk ◽  
Venous Thromboembolic ◽  
Reversible Method ◽  
Thrombotic Complications

Hormonal contraception is the most popular and effective reversible method for preventing unwanted pregnancy exerting multiple prophylactic and therapeutic effect along with contraceptive activity. The main adverse coupled to combined oral contraceptives (COCs) is its impact on the hemostasis and increased risk of venous thromboembolic complications. A great evolutionary path has been travelled after beginning application of hormonal contraception to reduce dose of its estrogen component and improving quality of gestagen component. Nevertheless, thrombotic complications related to COCs use still remain a pressing issue not only due to disease severity and high mortality rate from pulmonary embolism (PE), but also due to the difficulties in its timely diagnostics. Here we describe a clinical case of a 19-year-old patient suffering from vena cava inferior thrombosis complicated by PE after using COCs.

Platelet Adhesiveness in Symptomatic Women Taking Oral Contraceptives

1971 ◽  
Vol 26 (03) ◽  
pp. 426-430 ◽  
Author(s):  
T. F Zuck ◽  
J. J Bergin ◽  
Jane M. Raymond ◽  
W. R Dwyre ◽  
D. G Corby
Keyword(s):  
Oral Contraceptives ◽  
Platelet Adhesiveness ◽  
Combined Oral Contraceptives ◽  
Increased Risk ◽  
Normal Women ◽  
Asymptomatic Women

SummaryPlatelet adhesiveness to glass was determined in several groups of women. Increases were found in women developing thrombovascular symptoms while taking combined oral contraceptives, compared to both normal women and asymptomatic users of oral contraceptives. Despite this increase, overlap of the groups did not permit discrimination between symptomatic and asymptomatic women. However, it is possible, that in concert with other coagulation changes, platelet adhesiveness to glass may prove adjunctive in defining women at increased risk of developing thrombovascular symptoms while taking oral contraceptives, and further define the mechanism of the increased risk.

Folate contraception and clinical practice

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 101-107
Author(s):  
Vera N. Prilepskaya ◽  
Lana L. Bostandzhian
Keyword(s):  
Oral Contraceptives ◽  
Hormonal Contraception ◽  
The Body ◽  
Reproductive Age ◽  
Folate Supplementation ◽  
Combined Oral Contraceptives ◽  
Dosage Regimens ◽  
Gynecological Diseases ◽  
Unwanted Pregnancies ◽  
Fetal Malformations

Since the first pill, there has been a significant evolution of hormonal contraception: low- and micro-dose drugs have appeared, drugs with components as close as possible to endogenous hormones have been developed, new dosage regimens and routes of contraceptive administration have been created. Modern combined oral contraceptives are not only used to prevent unwanted pregnancies, but are also widely used to treat a number of gynecological and non-gynecological diseases. In recent years, two new combined oral contraceptives with folate supplementation have been developed. The main purpose of adding folate to contraceptives is the prevention of fetal malformations, which is ensured by an increase in the level of folate in the body of women of reproductive age against the background of contraception and after its withdrawal.

scholarly journals Lamin A/C mutation is independently associated with an increased risk of arterial and venous thromboembolic complications

2013 ◽  
Vol 168 (1) ◽  
pp. 472-477 ◽  
Author(s):  
Ingrid A.W. van Rijsingen ◽  
Annemieke Bakker ◽  
Donija Azim ◽  
Johanna F. Hermans-van Ast ◽  
Anneke J. van der Kooi ◽  
...  
Keyword(s):  
Lamin A ◽  
Thromboembolic Complications ◽  
Increased Risk ◽  
Venous Thromboembolic

scholarly journals PREVENTION OF VENOUS THROMBOEMBOLIC COMPLICATIONS IN REPLACEMENT ARTHROPLASTY PERFORMANCE IN PATIENTS WITH ASSOCIATED CHRONIC DISEASES OF LOWER EXTREMITIES VEINS

2016 ◽  
Vol 175 (3) ◽  
pp. 90-93
Author(s):  
V. V. Sabel’Nikov ◽  
O. V. Zlobin ◽  
A. I. Prokopets ◽  
A. O. Denisov ◽  
A. Yu. Avetyan
Keyword(s):  
Chronic Diseases ◽  
Treatment Strategy ◽  
Thromboembolic Complications ◽  
Clinical Recommendations ◽  
Replacement Arthroplasty ◽  
Number Of Patients ◽  
Venous Thromboembolic ◽  
Preparation Period ◽  
Thrombotic Complications ◽  
The Common

A number of patients with problems of major joints increases every year. These patients need the replacement arthroplasty. The rate of thrombotic complications rises in given category of patients simultaneously with the increase of the number of performed operations. There weren’t well-defined instructions of management of the patients with associated chronic vein diseases at the preparation period for arthroplasty performance in spite of the presence of clinical recommendations for prevention of thromboembolic complications. The authors analyzed the experience of management of such patients and presented these data for doctors from polyclinic and hospitals in order to apply the common treatment strategy.

Combined oral contraceptives in improving quality of young women’s lives

2019 ◽  
Vol 1 (1) ◽  
pp. 15-18
Author(s):  
A. L. Tikhomirov ◽  
T. A. Yudina ◽  
D. I. Burchakov
Keyword(s):  
Side Effects ◽  
Oral Contraceptives ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Combined Oral Contraceptives ◽  
Distinctive Features ◽  
Women's Lives ◽  
Combined Hormonal Contraceptive

Compliance with the use of combined hormonal contraceptive drugs containing drospirenone is presented. The use of such drugs enhances the use of hormonal contraception. The distinctive features of the drugs are considered: reliable contraception, reduced severity of side effects, additional positive preventive and curative effects.

Risks of adverse vascular events associated with the use of combined oral contraceptives

2021 ◽  
Vol 20 (5) ◽  
pp. 108-112
Author(s):  
S.M. Markin ◽  
◽  
Ya.V. Gitsuk ◽  
A.I. Mordovin ◽  
E.A. Kudinova ◽  
...  
Keyword(s):  
Adverse Events ◽  
Oral Contraceptives ◽  
Varicose Veins ◽  
Vascular Events ◽  
Combined Oral Contraceptives ◽  
Physiological Conditions ◽  
Hemostatic System ◽  
Venous Thromboembolic ◽  
Venous Disorders ◽  
Venous Wall

Combined oral contraceptives (COCs) are now widely used. There are some doubts regarding adverse events while taking COCs due to conflicting research data, which requires detailed clarification of all risks and the incidence of adverse events. One of the most common complaints of patients taking COCs is the occurence of unaesthetic varicose veins of the lower extremities. However, no data to support this have been found in the literature. The authors describe the reversible effect of COCs on the venous wall tone and the formation of hormone-induced phlebopathy, which is safely stopped by original phlebotonics. Potentially significant adverse vascular events associated with the use of COCs include venous thromboembolic complications, which are directly proportional to the duration of drug administration and its composition. It is also noted that the use of COCs has no significant effect on the hemostatic system, which has some limitations in terms of laboratory control. Conclusion. СOCs have some effect on the venous wall, but the progression of chronic venous disorders tends to have another source. There are risks of thrombosis, but significantly lower than certain physiological conditions in women. Key words: hemostasis, adverse events, oral contraceptives, thrombosis, phlebopathy

Thromboembolic Events in Children and Young Adults With Pediatric Sarcoma

2007 ◽  
Vol 25 (12) ◽  
pp. 1519-1524 ◽  
Author(s):  
Ido Paz-Priel ◽  
Lauren Long ◽  
Lee J. Helman ◽  
Crystal L. Mackall ◽  
Alan S. Wayne
Keyword(s):  
Pulmonary Embolism ◽  
Young Adults ◽  
Vena Cava ◽  
Thromboembolic Events ◽  
Pediatric Sarcoma ◽  
Increased Risk ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Localized Disease ◽  
Children And Young Adults

Purpose Adults with malignancy are at increased risk for venous thromboembolic events (TEs). However, data in children and young adults with cancer are limited. Patients and Methods To determine the risk and clinical features of TEs in children and young adults with sarcoma, we reviewed records on 122 consecutive patients with sarcoma treated from October 1980 to July 2002. Results Twenty-three TEs were diagnosed in 19 of 122 (16%; 95% CI, 10% to 23%) patients. Prevalence by diagnosis was Ewing sarcoma, eight of 61 (13%); osteosarcoma, two of 20 (10%); rhabdomyosarcoma, four of 26 (15%); and other sarcomas, five of 15 (33%). TEs developed in 23% of patients with metastases at presentation versus 10% with localized disease (odds ratio, 2.59; 95% CI, 0.9 to 7.1; P < .06). Fifty-three percent of patients with thrombosis had a clot at presentation. A lupus anticoagulant was detected in four of five evaluated patients. There was a single fatality due to pulmonary embolism. Patients who were diagnosed with cancer after 1993 had a higher rate of TE (7% v 23%; P < .015). Of the 23 events, 43% were asymptomatic. Main sites of thromboses were deep veins of the extremities (10 of 23; 43%), pulmonary embolism (five of 23; 22%), and the inferior vena cava (four of 23; 17%). TEs were associated with tumor compression in eight of 23 (35%) and with venous catheters in three of 23 (13%). Conclusion Thromboembolism is common in pediatric patients with sarcomas. Thromboses are detected frequently around the time of oncologic presentation, may be asymptomatic, and seem to be associated with a higher disease burden. Children and young adults with sarcoma should be monitored closely for thrombosis.

scholarly journals Combined Oral Contraceptives and Venous Thromboembolism: Review and Perspective to Mitigate the Risk

2021 ◽  
Vol 12 ◽  
Author(s):  
Laure Morimont ◽  
Hélène Haguet ◽  
Jean-Michel Dogné ◽  
Ulysse Gaspard ◽  
Jonathan Douxfils
Keyword(s):  
Venous Thromboembolism ◽  
Oral Contraceptives ◽  
Health Care Professionals ◽  
Contraceptive Method ◽  
Natural Form ◽  
Thrombotic Risk ◽  
Combined Oral Contraceptives ◽  
Hereditary Thrombophilia ◽  
Increased Risk ◽  
The Impact

Many factors must be considered and discussed with women when initiating a contraceptive method and the risk of venous thromboembolism (VTE) is one of them. In this review, we discuss the numerous strategies that have been implemented to reduce the thrombotic risk associated with combined oral contraceptives (COCs) from their arrival on the market until today. Evidences suggesting that COCs were associated with an increased risk of VTE appeared rapidly after their marketing. Identified as the main contributor of this risk, the dosage of the estrogen, i.e., ethinylestradiol (EE), was significantly reduced. New progestins were also synthetized (e.g., desogestrel or gestodene) but their weak androgenic activity did not permit to counterbalance the effect of EE as did the initial progestins such as levonorgestrel. Numerous studies assessed the impact of estroprogestative combinations on hemostasis and demonstrated that women under COC suffered from resistance towards activated protein C (APC). Subsequently, the European Medicines Agency updated its guidelines on clinical investigation of steroid contraceptives in which they recommended to assess this biological marker. In 2009, estradiol-containing COCs were marketed and the use of this natural form of estrogen was found to exert a weaker effect on the synthesis of hepatic proteins compared to EE. In this year 2021, a novel COC based on a native estrogen, i.e., estetrol, will be introduced on the market. Associated with drospirenone, this preparation demonstrated minor effects on coagulation proteins as compared with other drospirenone-containing COCs. At the present time, the standard of care when starting a contraception, consists of identifying the presence of hereditary thrombophilia solely on the basis of familial history of VTE. This strategy has however been reported as poorly predictive of hereditary thrombophilia. One rationale and affordable perspective which has already been considered in the past could be the implementation of a baseline screening of the prothrombotic state to provide health care professionals with objective data to support the prescription of the more appropriate contraceptive method. While this strategy was judged too expensive due to limited laboratory solutions, the endogenous thrombin potential-based APC resistance assay could now represent an interesting alternative.

scholarly journals ANALYSIS OF CLINICAL CASES OF VENOUS THROMBOEMBOLIC COMPLICATIONS DURING PREGNANCY, CHILDBIRTH AND EARLY POSTPARTUM PERIOD

2020 ◽  
Vol 75 (3) ◽  
pp. 170-174
Author(s):  
A.A. Poliantsev ◽  
◽  
D.V. Frolov ◽  
M.D. Andreeva ◽  
D.V. Linchenko ◽  
...  
Keyword(s):  
Postpartum Period ◽  
Vena Cava ◽  
Drug Prevention ◽  
Thromboembolic Complications ◽  
National Guidelines ◽  
Early Postpartum Period ◽  
Insufficient Amount ◽  
Early Postpartum ◽  
Venous Thromboembolic ◽  
Clinical Cases

Aim: based on clinical cases, to show an insufficient amount of measures for the prevention of venous thromboembolic complications during pregnancy, childbirth and the early postpartum period when women are managed in accordance with national guidelines. Materials and methods: the retrospective study included 25 women aged (28,1 ± 6,3) years, hospitalized during pregnancy and early postpartum period in the department of vascular surgery due to venous thrombosis of the inferior vena cava system. All patients underwent ultrasound duplex scanning of blood vessels to verify the diagnosis. The therapeutic approach to patients is considered from the standpoint of domestic and international recommendations. Results: thrombosis was most often complicated by the third trimester of pregnancy and the early postpartum period – 56 % of all cases. In the majority of patients, thrombosis was widespread and proximal: in 72 % of women, the upper border of the thrombus was localized at the level of the iliac veins. When scoring the risk of developing venous thromboembolic complications according to the 2015 Royal College of Obstetricians and Gynecologists scale in the patients participating in the study, it turned out that most of them were shown drug prevention. Conclusions: it is necessary to use national and international recommendations to prevent thrombotic complications in pregnant women and postpartum women.

Changing physicians’ attitudes regarding anticoagulant therapy for novel coronavirus infection in 2021.

2021 ◽  
Author(s):  
Е.В. Ройтман ◽  
С.М. Маркин ◽  
П.Ф. Кравцов ◽  
К.В. Мазайшвили
Keyword(s):  
Anticoagulant Therapy ◽  
Process Development ◽  
Oral Anticoagulants ◽  
Vascular Diseases ◽  
Medical Community ◽  
Treatment And Prevention ◽  
Increased Risk ◽  
Venous Thromboembolic ◽  
Thrombotic Complications ◽  
Novel Coronavirus

Введение. Несмотря на комплекс противоэпидемических мероприятий, включающих и массовую вакцинацию, распространение COVID-19-инфекции во второй половине 2021 г. продолжается. Отчасти это обусловлено появлением новых, более агрессивных штаммов. Так или иначе, поступление вируса SARS-CoV-2 в организм человека по-прежнему сопровождается развитием COVID-19-ассоциированной коагулопатии, реализующейся в различных тромботических осложнениях. Актуальные клинические рекомендации уже 12-го пересмотра описывают основные подходы к лечению и профилактике венозных тромбоэмболических осложнений, однако реализация их не всегда представляется возможной. Несмотря на растущую информированность клиницистов относительно патогенетических аспектов развития инфекционного процесса, в реальной практике все также имеет место значительное количество отклонений и нарушений, в том числе носящих системный характер, во многом связанных с избыточным желанием предотвратить отдельные из них. Цель исследования: изучение изменения состояния реальной клинической практики в области лечения и профилактики развития тромботических осложнений у пациентов, страдающих новой COVID-19-инфекцией. Материалы и методы. В основе работы – 2 анонимных опроса, проведенных в феврале и августе 2021 г., в которых приняли участие врачи-специалисты (соответственно, 223 и 131), занимающиеся лечением пациентов с хроническими и острыми заболеваниями сосудов. В опросник было включено 17 вопросов, описывающих отношение врачей к проблеме, касающихся выбора тактики лечения, применения фармацевтических препаратов и методов контроля системы гемостаза. Результаты. Результаты опросов выявили сохраняющуюся высокую степень информированности медицинского сообщества об увеличении риска тромботических осложнений при COVID-19 и необходимости коррекции COVID-19-ассоциированной коагулопатии путем назначения адекватной антикоагулянтной терапии (АКТ). Максимальную степень доверия среди респондентов при АКТ в условиях стационара сохраняют низкомолекулярные гепарины (НМГ), хотя растет количество врачей, рекомендующих новые (прямые) оральные антикоагулянты (НОАК/ПОАК), несмотря на отсутствие качественных рандомизированных исследований, подтверждающих их эффективность. Зафиксирован рост информированности респондентов в вопросах, касающихся лабораторного контроля за системой гемостаза. Заключение. Полученные результаты свидетельствуют о необходимости продолжения информационной кампании в отношении профилактики COVID-19-ассоциированной коагулопатии среди медицинских работников. Background. Despite a set of anti-epidemic measures, including mass vaccination, the spread of COVID-19-infection in the second half of 2021 continues. This is largely due to the emergence of new, more aggressive strains. One way or another, entry of SARS-CoV-2 virus into human body is still accompanied by development of COVID-19-associated coagulopathy realized in various thrombotic complications. Current clinical guidelines, already the 12th revision, describe the main approaches to treatment and prevention of venous thromboembolic complications, but their implementation is not always possible. Despite the increasing awareness of clinicians concerning pathogenetic aspects of infectious process development, a significant number of deviations and disorders, including those of systemic nature, still occur in real practice largely due to excessive desire to prevent some of them. Objectives: to study real clinical practice changes in treatment and prevention of thrombotic complications in patients with new COVID-19-infection. Materials/Methods. The work was based on two anonymous surveys conducted in February and August 2021 with the participation of 223 and 131 physicians treating patients with chronic and acute vascular diseases, respectively. The questionnaires included 17 questions describing physicians’ attitudes regarding treatment choices, use of pharmaceuticals, and methods of hemostasis monitoring. Results. The results of the questionnaires revealed a continuing high degree of awareness among the medical community about the increased risk of thrombotic complications in COVID-19 and the need to correct coagulopathy by prescribing adequate anticoagulant therapy (ACT). Low molecular weight heparins (LMWHs) retain the highest degree of confidence among respondents in inpatient ACT, although the number of physicians recommending new oral anticoagulants (NOACs) is increasing, despite the lack of high-quality randomized trials confirming their effectiveness. There has been an increase in respondents’ awareness of issues related to hemostasis laboratory control. Conclusions. The results obtained indicate the need to continue the information campaign regarding the prevention of COVID-19-coagulopathy among healthcare workers.

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