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[Phlebology and gynecology].

The authors give the pattern of several situations where are added phlebological and gynecological diseases. They summarize the several treatments and the practical uses for this. Medicolegal viewpoints are also taken in account.

Contraceptives, Oral, Hormonal↗
PubMed1989

Contraceptive methods in the McCune-Albright syndrome.

We describe the case of a woman with McCune-Albright syndrome who had a pathological bone fracture while being treated with an oral contraceptive. In this syndrome the bone lesions contain estrogen and progesterone receptors. The possibility of progression of the bone lesions during pregnancy is well-known. We judge the use of oral contraceptives to be dangerous in this syndrome; the affected women must be orientated towards alternative contraceptive methods.

Adult↗
PubMed1989

Oral contraceptive use in women with chronic medical conditions.

Health care practitioners are often faced with the dilemma of whether or not to provide oral contraceptives to women who have certain chronic medical conditions. This article reviews literature regarding the use of oral contraceptives in clients with histories of gestational diabetes, mitral valve prolapse or sickle cell disease. Recommendations for management are provided regarding oral contraceptive use in women with these conditions.

Anemia, Sickle Cell↗
PubMed1989

[Profile of cardiovascular risk factors in females with a definitive myocardial infarct up to 49 years of age].

The appearance of myocardial infarctions in fertile women is to agree upon the concept of cardiovascular risk factors. Women without diabetes showed in 3 age groups up to 49 years 2.5-3.1 factors and with diabetes 4.4-4.8 factors, such as smoking, hyperlipoproteinaemia, hypertension, obesity, oral contraceptives, hyperuricaemia and diabetes mellitus, respectively. No female patient with infarction was free of risk factors. The obesity can be regarded as indicator for the presence of further risk factors. A critical indication for oral contraceptives is recommended, if already one of the factors, such as smoking, hyperlipoproteinaemia, hypertension, obesity or diabetes mellitus is present, or, if possible, its removal before ordination. Also low-dose oral contraceptives must be regarded as a potential risk factor up to further clarification.

Adult↗
PubMed1987

Medical aspects of contraception.

It is evident that choice of contraceptive has important medical implications, whether a mechanical or a hormonal method is elected. Each technology has unique benefits and risks, constraints, applicability, and inconvenience. Wise advice in a medical context must be based on thorough familiarity with the options available to each woman.

Adult↗
PubMed1987

Pill method failures.

This is a study over a four year period from November 1981 to December 1985 documenting 163 cases of pill method failures in reliable pill takers. In over one third of these cases (36%) there were no predisposing factors. Significant factors which were associated with failure were diarrhoea and/or vomiting in 35%, and breakthrough bleeding on the combined pill in 21%. While there is controversy in the literature about the role of antibiotics in causing pill failure, this study found 23% of failures associated with antibiotic use. Two failures occurred on anticonvulsant medication. Recommendations are made for improved instructions to patients.

Abortion, Induced↗
PubMed1986

[Cerebral venous thrombosis associated with the use of oral contraceptives].

The entity of cerebrovascular diseases associated with the use of oral contraceptives is well known but quite rare in Japan in contrast to Western countries. We recently encountered a 38 years old female with cerebral venous thrombosis considered to be caused by oral contraception. This patient took oral contraceptives for 17 days following therapeutic abortion, and was transferred to our hospital because of disturbed consciousness. CT scans disclosed a right temporo-occipital subcortical hemorrhagic infarction and bilateral thalamic infarction. Cerebral angiograms showed non-filling of cortical veins in the same area. The internal cerebral vein, vein of Galen and right transverse sinus were not visualized either. The hematoma and necrotic tissue were removed to avoid farther neurological deterioration. The brain was swollen and hyperemic, and thrombosed cortical veins were clearly recognized at operation. Twelve cases, including ours, of cerebrovascular diseases associated with oral contraception were reported up to now in Japan, and only 3 of them were diagnosed objectively as venous or sinus thrombosis. The average age of these 12 cases was 34 years old and many of them experienced abortion or therapeutic abortion. There was no relationship between the dose of estrogen and the onset of cerebrovascular diseases. We believe that the onset of this pathological state is based on gynecological hypercoagulable state, and the oral contraception may play a role of a trigger. Oral contraception should be contraindicated in patients with gynecological hypercoagulable state, hypertension and/or smoking habit.

Adult↗