Inmagic CS/WebPublisher PRO found 2179 records

Your search found 2179 record(s).
New Basic Search | New Advanced Search | POPLINE Document Delivery Policy

Subscription may be needed for full text

Peer Reviewed

Title: Use of contraceptive methods by women with current venous thrombosis on anticoagulant therapy: a systematic review.
Author: Culwell KR; Curtis KM
Source: Contraception. 2009 Oct;80(4):337-45.
Abstract: BACKGROUND: As nearly all women with venous thromboembolism (VTE) will be treated with anticoagulant therapy, it is important to consider how anticoagulation affects the safety of contraceptive use. STUDY DESIGN: We conducted a systematic review of the literature regarding use of contraceptive methods in women with current VTE on anticoagulant therapy. Due to the limited direct evidence that was identified, we expanded our search to include women on anticoagulant therapy for indications other than VTE and women with bleeding disorders. RESULTS: Six articles met our inclusion criteria. Three observational studies found the levonorgestrel-releasing IUD (LNG-IUD) was an effective treatment for menorrhagia for women on anticoagulation therapy or with bleeding disorders. Prevention of recurrent hemorrhagic ovarian cysts was seen in women on chronic anticoagulation treated with depot-medroxyprogesterone acetate (DMPA) in one small observational study. Among women with bleeding disorders, no complications were seen in 16 women with placement of the LNG-IUD. One pharmacokinetic study found no statistically significant interaction between combined oral contraceptives and warfarin. Other than one case report, no evidence was found regarding the risk of recurrent thrombosis in women on anticoagulation therapy using a contraceptive method. CONCLUSION: The majority of studies in this review examined treatment effects of the LNG-IUD or DMPA on complications of anticoagulation and found overall beneficial effects of their use in these circumstances. Minimal evidence in women with inherited bleeding disorders suggests that insertion of the LNG-IUD does not pose major bleeding risks in these women with appropriate management.
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | THROMBOSIS | COMPLICATIONS | DRUGS | IUD, HORMONE RELEASING | IUD SIDE EFFECTS | INSERTION | DEPO-PROVERA | BLOOD COAGULATION EFFECTS | HEREDITARY DISEASES | MENSTRUATION DISORDERS | CONTRACEPTIVE SAFETY | Thromboembolism | Embolism | Vascular Diseases | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | IUD | Contraceptive Methods | Contraception | Family Planning | Medroxyprogesterone Acetate | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Hematological Effects | Hemic System | Physiology | Biology | Safety | Public Health
Document Number: 342773

Title: Thrombophilic conditions in the adolescent: the gynecologic impact.
Author: Dietrich JE; Yee DL
Source: Obstetrics and Gynecology Clinics of North America. 2009 Mar;36(1):163-75.
Abstract: As Virchow's triad suggests, a fine balance exists between the vascular wall, intravascular contents, and dynamic blood flow, such that a shift in this balance predisposes to thrombosis. Although thromboembolic events (TEs) are relatively infrequent in adolescents, the morbidity and mortality associated with TEs can be significant. Over the past 15 years, TEs and inherited and acquired thrombophilic conditions underlying them have become increasingly recognized in teens at risk, with combined hormonal contraception constituting one of the most significant of these risk factors. Therefore, managing gynecologic problems in teens who have thrombophilic conditions can be challenging. It is important to have a clear understanding about safe options available to help address adolescent gynecologic concerns in this setting and to manage situations collaboratively with a hematologist.
Language: English
Keywords:
UNITED STATES OF AMERICA | RECOMMENDATIONS | ADOLESCENTS, FEMALE | GYNECOLOGY | THROMBOSIS | RISK FACTORS | HEREDITARY DISEASES | CONTRACEPTIVE AGENTS, FEMALE | ORAL CONTRACEPTIVES, COMBINED | BLOOD COAGULATION EFFECTS | SCREENING | PROGESTERONE | CONTRACEPTIVE METHODS | Developed Countries | North America | Americas | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medicine | Health Services | Delivery of Health Care | Health | Thromboembolism | Embolism | Vascular Diseases | Diseases | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Hematological Effects | Hemic System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Progestational Hormones | Hormones | Endocrine System
Document Number: 342856

Peer Reviewed

Title: Use of combined oral contraceptives post abortion.
Author: Gaffield ME; Kapp N; Ravi A
Source: Contraception. 2009 Oct;80(4):355-62.
Abstract: BACKGROUND: Providing combined oral contraceptives (COCs) following surgical or medical induced abortion offers women an opportune moment to initiate a reliable contraceptive method. STUDY DESIGN: We conducted a systematic review, searching MEDLINE and The Cochrane Library for articles in any language concerning COC use following spontaneous, induced (medical or surgical) or septic abortion, from 1966 through June 2008. Seven articles were identified and evaluated using the United States Preventive Services Task Force system. RESULTS: Immediate COC initiation after first-trimester medical or surgical induced abortion did not increase side effects or prolong vaginal bleeding compared with use of a placebo, copper-bearing intrauterine device (IUD), nonhormonal contraceptive method or COC initiation at a later time. Initiating COCs after first-trimester surgical abortion produced small increases in coagulation parameters compared with IUD use; although they are statistically significant, their clinical relevance is unlikely. No study examined second-trimester induced or spontaneous abortion, or septic abortion. CONCLUSIONS: Evidence shows that COCs can be safely initiated immediately following surgical and medical abortion in the first-trimester of pregnancy.
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | ABORTION | ABORTION, SPONTANEOUS | PREGNANCY, FIRST TRIMESTER | POSTABORTION CARE | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE SAFETY | MENSTRUATION | ORAL CONTRACEPTIVES, SIDE EFFECTS | BLOOD COAGULATION EFFECTS | Fertility Control, Postconception | Family Planning | Pregnancy Complications | Diseases | Pregnancy | Reproduction | Health Services | Delivery of Health Care | Health | Oral Contraceptives | Contraceptive Methods | Contraception | Safety | Public Health | Hematological Effects | Hemic System | Physiology | Biology
Document Number: 342771 Notification

Peer Reviewed

Title: Oral contraceptives alone and with spironolactone increase sCD40 ligand in PCOS patients.
Author: Kebapcilar L; Bilgir O; Taner CE; Kebapcilar AG; Kozaci DL; Alacacioglu A; Yildiz Y; Yuksel A; Sari I
Source: Archives of Gynecology and Obstetrics. 2009 Aug 5;
Abstract: BACKGROUND: The present study was designed to determine the effect of oral contraceptives (OCP) and OCP plus spironolactone (Sp) on plasma soluble CD40L levels in polycystic ovary syndrome (PCOS) patients. METHODS: Fifty-six women with PCOS were randomized into two treatment protocols: ethinylestradiol + cyproterone acetate (2 mg, EE/CA; n = 28), and EE/CA with spironolactone (Sp; n = 28). Plasma sCD40L levels were measured before and after a 3-month treatment. RESULTS: Before the initiation of treatment, the sCD40L levels were not significantly different between the groups [EE/CA (1.33 ng/mL) vs. EE/CA + Sp (1.23 ng/mL); P > 0.05]. In the post-treatment period, sCD40L concentrations were increased compared with pre-treatment values in the EE/CA and EE/CA + Sp groups (1.33 vs. 2.70 ng/mL, P = 0.011; and 1.23 vs. 2.41 ng/mL, P = 0.017; respectively). CONCLUSION: Increased plasma concentrations of sCD40L are associated with OCP and OCP + Sp treatment regimens in PCOS patients.
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CLINICAL RESEARCH | CLIENTS | OVARIAN CYSTS | TREATMENT | ORAL CONTRACEPTIVES | DRUGS | IMMUNOLOGICAL EFFECTS | BLOOD COAGULATION EFFECTS | LIPID METABOLIC EFFECTS | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Immunity | Immune System | Physiology | Biology | Hematological Effects | Hemic System | Lipids
Document Number: 342417

Peer Reviewed

Title: The effect of levonorgestrel-releasing intrauterine device on menorrhagia in women taking anticoagulant medication after cardiac valve replacement.
Author: Kilic S; Yuksel B; Doganay M; Bardakci H; Akinsu F; Uzunlar O; Mollamahutoglu L
Source: Contraception. 2009 Aug;80(2):152-7.
Abstract: BACKGROUND: This study was conducted to evaluate the effect of levonorgestrel-releasing intrauterine devices (LNG-IUDs) on menorrhagia in patients receiving anticoagulant therapy after cardiac valve replacement. STUDY DESIGN: Forty women with menorrhagia who underwent cardiac valve replacement and were taking anticoagulant medication were enrolled in the study. The women were randomly divided into two groups: LNG-IUDs were inserted into 20 women in Group 1 over the first 3 days of menstrual bleeding, while the women in Group 2 were followed without any intervention. The activated partial thromboplastin time, prothrombin time, international normalized ratio, hematocrit level, hemoglobin level, ferritin level and pictorial bleeding assessments for the quantity of menstrual bleeding were recorded. RESULTS: Three months after insertion of LNG-IUDs, the women in Group 1 had a significant decrease in blood loss and higher hemoglobin, hematocrit and ferritin values. No difference was detected for these parameters in the control group at the third and sixth months of the study. Coagulation parameters did not differ between the two groups. CONCLUSION: LNG-IUDs can be considered as an effective non-surgical treatment for menorrhagia in women receiving anticoagulant therapy after cardiac valve replacement.
Language: English
Keywords:
TURKEY | RESEARCH REPORT | CONTROL GROUPS | CLIENTS | IUD, HORMONE RELEASING | LEVONORGESTREL | MENORRHAGIA | CARDIOVASCULAR EFFECTS | POSTOPERATIVE PROCEDURES | DRUGS | BLOOD COAGULATION EFFECTS | Europe, Southeastern | Europe | Developing Countries | Research Methodology | Program Activities | Programs | Organization and Administration | IUD | Contraceptive Methods | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Menstruation Disorders | Diseases | Physiology | Biology | Surgery | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Hematological Effects | Hemic System
Document Number: 342392

Title: Acute Renal Vein Thrombosis, Oral Contraceptives, and Protein S Deficiency: A Successful Catheter-Directed Thrombolysis.
Author: Kim HK; Choi HH; Lee JM; Huh S
Source: Annals of Vascular Surgery. 2009 Jul 22;
Abstract: Acute renal vein thrombosis (RVT) is a rare but noteworthy form of venous thromboembolism. Traditional management has been systemic anticoagulation with heparin, followed by warfarin. We report a case of acute RVT with multiple pulmonary emboli that occurred in a 40-year-old woman who was taking oral contraceptives and was subsequently found to have protein S deficiency. The patient was treated with catheter-directed thrombolysis, and complete resolution of the RVT was achieved. This case suggests that oral contraceptive use in a patient with protein S deficiency may interact in a synergistic manner in the pathogenesis of thrombosis. Also, we believe that catheter-directed thrombolysis is warranted in selective cases in the absence of overriding contraindications.
Language: English
Keywords:
REPUBLIC OF KOREA | SUMMARY REPORT | CASE HISTORIES | CLIENTS | RENAL EFFECTS | THROMBOSIS | TREATMENT | ORAL CONTRACEPTIVES | SERUM PROTEIN EFFECTS | RISK FACTORS | BLOOD COAGULATION EFFECTS | Asia, Eastern | Asia | Developed Countries | Data Collection | Research Methodology | Program Activities | Programs | Organization and Administration | Urogenital Effects | Urogenital System | Physiology | Biology | Thromboembolism | Embolism | Vascular Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Contraceptive Methods | Contraception | Family Planning | Hematological Effects | Hemic System
Document Number: 342328

Title: Symptomatic ileofemoral DVT after onset of oral contraceptive use in women with previously undiagnosed May-Thurner Syndrome.
Author: Murphy EH; Davis CM; Journeycake JM; Demuth RP; Arko FR
Source: Journal of Vascular Surgery. 2009 Mar;49:697-703.
Abstract: OBJECTIVE: May-Thurner syndrome is characterized by left common iliac obstruction secondary to compression of the left iliac vein by the right common iliac artery against the fifth-lumbar vertebra. This anatomic variant results in an increased incidence of left-sided deep venous thrombosis (DVT). Furthermore, while a preponderance of left-sided DVT has been demonstrated in women during pregnancy and oral contraceptive use, patients are not typically screened for this condition after developing a left-sided DVT. As anticoagulation alone is ineffective for DVT treatment in the setting of May-Thurner anatomy, more aggressive treatment is warranted. Failure to diagnosis this condition predisposes these women to the unnecessary risks of recurrent DVT and post-thrombotic syndrome. METHODS: We present the occurrence of 7 adolescent patients with previously undiagnosed May-Thurner syndrome who presented with DVT after the initiation of oral contraceptive steroids (OCP) use. All 7 patients elected to proceed with mechanical thrombolysis/catheter based thrombolysis followed by endovascular stenting and were postoperatively treated with 6 months of warfarin. RESULTS: Mean patient age was 18.3 +/- 3.3 years (range, 16-24 years). Mean time to presentation after initiation of OCP was 5 weeks (range, 2-10 weeks). Mean time to intervention was 16.8 days (range, 10-24 days). All patients were treated with mechanical thrombectomy. Our rate of intraoperative clot resolution was 100%. All 7 patients were treated with self expanding nitinol stents after angioplasty of the iliac vein stenosis with resolution of the stenotic segment. Primary stent patency is 100% (7/7). Mean follow-up time is 13 +/- 13.84 months (range, 6-42 months). There have been no long-term complications related to surgical treatment or anticoagulation. All 7 patients have experienced resolution of left leg swelling and pain and have no evidence of post-thrombotic syndrome or DVT recurrence to date. CONCLUSIONS: Women on OCPs presenting with left-sidediliofemoral DVT should be screened for hypercoagulable disorders and underlying May-Thurner anatomy. Treatment of May-Thurner syndrome should include thrombolysis/thrombectomy and anticoagulation for current DVT in addition to angioplasty and stenting of the underlying obstruction.
Language: English
Keywords:
TEXAS | RESEARCH REPORT | CLINICAL RESEARCH | ADOLESCENTS, FEMALE | VASCULAR DISEASES | ORAL CONTRACEPTIVES, SIDE EFFECTS | THROMBOSIS | TIME FACTORS | TREATMENT | SURGERY | BLOOD COAGULATION EFFECTS | EDEMA | PAIN | United States of America | North America | Americas | Developed Countries | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Contraceptive Safety | Safety | Public Health | Health | Thromboembolism | Embolism | Population Dynamics | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Hematological Effects | Hemic System | Physiology | Biology | Signs and Symptoms
Document Number: 329670

10.

Title: Effect of low dose oral pill on haemostatic parameters in a set of Pakistani population.
Author: Afsar NA; Barakzai Q; Adil SN
Source: Journal of Pakistan Medical Association. 2008 May;58(5):229-233.
Abstract: The purpose of this study was to observe the adverse effects of low dose combination contraceptive pills on blood coagulation in a set of local population. Between December 2002 to December 2003 a comparative cross-sectional study was conducted at the Department of Pharmacology, Ziauddin Medical University, Karachi and Aga Khan University Hospital, Karachi. Fifty women of reproductive age were divided in two equal groups; one being the users of combination oral contraceptive pills (ethinyl estradiol and levonorgestrel) and the other being matching controls not taking any hormonal contraceptives. We studied, CBC, PT and INR, APTT, BT and platelet aggregation against ADP, collagen, epinephrine and ristocetin. PT, INR, and platelet aggregation response to ADP, collagen, epinephrine, and ristocetin were not significantly different among the groups. However, APTT was shortened in users of contraceptives (p = 0.003). The referred oral contraceptive is associated with enhanced activity of intrinsic pathway of secondary haemostasis. (author's)
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | COMPARATIVE STUDIES | CROSS SECTIONAL ANALYSIS | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, LOW-DOSE | BLOOD COAGULATION EFFECTS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Hematological Effects | Hemic System | Physiology | Biology
Document Number: 327014

11.

Title: Meningococcal disease and meningitis.
Author: Branco RG; Amoretti CF; Tasker RC
Source: Jornal de Pediatria. 2007 May;83 Suppl 2:S46-S53.
Abstract: The objective was to review the literature relevant to diagnosis and management of meningococcal disease (MD). The source used was a non-systematic review of medical literature through the MEDLINE database using the terms meningococcal, septic shock, diagnosis, and treatment. Articles were selected according to their relevance to the objective of the study and according to the authors' opinion. MD is a leading cause of death due to infection in children. It progresses rapidly and a high level of suspicion is necessary for early diagnosis. Early intervention with aggressive fluid resuscitation and antibiotic therapy can significantly improve outcome. In the pediatric intensive care unit, a large amount of fluids may be required during the first few days and vasoactive drug infusions are often needed. Coagulopathy is frequent, but it has no specific treatment. The use of colloids and steroids may be beneficial, but other new therapies such as insulin and activated protein C still need further assessment. Rescue therapy with extracorporeal membrane oxygenation may be appropriate in cases complicated by severe acute respiratory distress syndrome, but not for refractory shock. Meningitis is often not diagnosed in MD because of the severity of illness and the inability to perform a lumbar puncture safely in a patient with coagulopathy, coma, or hemodynamic instability. When present, cerebral edema and altered cerebral blood flow are the main concerns. The use of osmolar solution may be necessary, but the main therapeutic intervention is to ensure adequate blood pressure for adequate cerebral perfusion. Seizures and hyponatremia should be aggressively treated. Steroids do not appear to affect outcome in meningococcal meningitis. MD is a life-threatening infection that requires early recognition and treatment. Time sensitive fluid resuscitation and antibiotic therapy are the most effective therapies for MD. Other therapies such as steroids may have a place in MD treatment but more definitive studies are necessary. (author's)
Language: English
Keywords:
UNITED KINGDOM | LITERATURE REVIEW | CHILDREN | MENINGITIS | CAUSES OF DEATH | EXAMINATIONS AND DIAGNOSES | ANTIBIOTICS | TREATMENT | BLOOD COAGULATION EFFECTS | EDEMA | CEREBROVASCULAR EFFECTS | Developed Countries | Europe, Western | Europe | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Central Nervous System Effects | Central Nervous System | Physiology | Biology | Mortality | Population Dynamics | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Drugs | Hematological Effects | Hemic System | Signs and Symptoms | Diseases
Document Number: 319429

12.

Title: Overt disseminated intravascular coagulation in obstetric patients.
Author: Kor-anantakul O; Lekhakula A
Source: Journal of the Medical Association of Thailand. 2007 May;90(5):857-864.
Abstract: The objective was to determine the incidence, etiology and outcome of treatment in obstetric patients complicated by overt disseminated intravascular coagulation (DIC). Medical records of 25 obstetric patients with a diagnosis of DIC in Songklanagarind University Hospital from January 1993 to December 2005 were reviewed. The incidence of overt DIC was 1 per 1,355 deliveries. Median maternal age was 30 years (range 17-44 years). Median duration of hospital stay was 10 days (range 0-32 days). The main associated conditions included abruptio placentae in 6 patients (24%), pregnancy-induced hypertension (PIH) in 5 (20%), amniotic fluid embolism in 4 (16%), acute fatty liver of pregnancy (AFLP) in 4 (16%), and HELLP syndrome in 3 (12%). A definite diagnosis of DIC was made in 8 patients (32%) with a median DIC score of 6 (range 5-7) and the remainder were clinically diagnosed with incomplete work-up. All patients received blood component replacement. Cesarean section was performed in 10 patients (40%) and hysterectomy in 9 patients (36%). Six patients died, giving a case mortality rate of 24%. Three were associated with amniotic fluid embolism and one of each with fulminant hepatitis, ALFP and HELLP syndrome. Thirteen of 24 fetuses (54%) died, most related to abruptio placentae (6/6, 100%), PIH (4/5, 80%), and amniotic fluid embolism (2/4, 50%). Various pregnancy-related conditions will predispose to DIC development. Early diagnosis with prompt treatment, including a quick decision for surgical intervention, and eradication of predisposing conditions would minimize maternal morbidity and mortality. (author's)
Language: English
Keywords:
THAILAND | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN | PREGNANCY | BLOOD COAGULATION EFFECTS | TREATMENT | PREGNANCY COMPLICATIONS | MORTALITY | CHILDBIRTH | OBSTETRICAL SURGERY | OBSTETRICS | Asia, Southeastern | Asia | Developing Countries | Research Methodology | Demographic Factors | Population | Reproduction | Hematological Effects | Hemic System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Diseases | Population Dynamics | Pregnancy Outcomes | Surgery
Document Number: 317805

13.
Peer Reviewed

Title: Should coagulation tests be used to determine which oral contraceptive users have an increased risk of thrombophlebitis?
Author: Comp PC
Source: Contraception. 2006;73:4-5.
Abstract: The increased risk of venous thrombosis in women taking oral contraceptives (OCs) has been recognized since the early 1960s. Finding hematologic links between OC use and thrombosis is an area of active investigation. Oral contraceptives elevate the plasma levels of some blood clotting factors, but only to a modest degree and the levels still remain in the normal range. However, some degree of risk of thrombosis may now be ascribed to these relatively minor changes. Changes also occur in the natural anticoagulant system of proteins in the blood whose job it is to prevent venous thrombosis. One of the acquired changes in blood clotting caused by OCs resembles the laboratory findings associated with the most common inherited risk factor for thrombosis, factor V Leiden. A considerable percentage of women are born with inherited risk factors favoring thrombosis; the additive effect of OCs plus an existing inherited risk factor has the potential to trigger an event of venous thrombosis. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | RECOMMENDATIONS | GENETIC TECHNIQUES | WOMEN | BLOOD COAGULATION EFFECTS | ORAL CONTRACEPTIVES, SIDE EFFECTS | THROMBOPHLEBITIS | RISK FACTORS | CONGENITAL ABNORMALITIES | TESTING | LABORATORY EXAMINATIONS AND DIAGNOSES | North America | Americas | Developed Countries | Examinations and Diagnoses | Demographic Factors | Population | Hematological Effects | Hemic System | Physiology | Biology | Contraceptive Safety | Safety | Public Health | Health | Thromboembolism | Embolism | Vascular Diseases | Diseases | Neonatal Diseases and Abnormalities | Measurement | Research Methodology
Document Number: 293353

15.
Peer Reviewed

Title: Comparative effects of a contraceptive vaginal ring delivering a nonandrogenic progestin and continuous ethinyl estradiol and a combined oral contraceptive containing levonorgestrel on hemostasis variables.
Author: Rad M; Kluft C; Menard J; Burggraaf J; de Kam ML
Source: American Journal of Obstetrics and Gynecology. 2006 Jul;195(1):72-77.
Abstract: This study aimed to compare the effects on hemostasis variables of a contraceptive vaginal ring with those of an oral contraceptive. Twenty-three and 22 healthy premenopausal women were randomized to the contraceptive vaginal ring (150 �g Nestorone and 15 �g ethinyl estradiol) or Stediril 30 during 3 cycles. Analysis of covariance was performed with baseline values as covariate. The contraceptive vaginal ring changed most hemostasis variables similarly but raised (95% confidence intervals of percent treatment differences) Factor VIIt (28% to 49%), extrinsic activated protein C resistance (14% to 65%), and sex hormone--binding globulin (117% to 210%) and lowered Protein S (--32% to --16%) and the global activated partial thromboplastin time-based activated protein C resistance (--12% to --2%) more than the oral contraceptive. The contraceptive vaginal ring affected some measured hemostasis variables and sex hormone--binding globulin differently from the oral contraceptive, most likely because of difference in androgenicity of the progestins. The results suggest that the contraindications for oral contraceptive use would also apply to the tested contraceptive vaginal ring. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | NEW YORK | RESEARCH REPORT | COMPARATIVE STUDIES | WOMEN | VAGINAL RING | ORAL CONTRACEPTIVES | THROMBOEMBOLISM | BLOOD COAGULATION EFFECTS | LEVONORGESTREL | ETHINYL ESTRADIOL | North America | Americas | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Embolism | Vascular Diseases | Diseases | Hematological Effects | Hemic System | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen
Document Number: 302810

16.
Peer Reviewed

Title: Acute promyelocytic leukemia: an unusual cause of fatal secondary postpartum hemorrhage.
Author: Sharma JB; Gupta N; Vimala N; Anand M; Deka D
Source: Archives of Gynecology and Obstetrics. 2006 Feb;273(5):310-311.
Abstract: Postpartum haemorrhage can rarely be associated with an underlying coagulation or haematological disorder. We wish to discuss a case of acute promyelocytic leukemia (APL) presenting as secondary postpartum hemorrhage (PPH), its clinical and pathological features and maternal outcome. We describe a 28-year-old woman who presented with secondary PPH accompanied by bleeding from gums, marked pallor, hematemesis, ecchymotic and purpuric spots all over the body, 8 days post-partum. Investigations revealed her to be having APL, a diagnosis not suspected by the referring clinic. She was given supportive therapy but died before chemotherapy could be started. The case emphasizes the importance of suspecting, investigating and energetically treating uncommon causes such as acute leukemia when an unusually severe clinical picture in a postpartum setting suggests such a possibility. This may prove to be life saving, particularly if the leukemia happens to be APL, a cancer with a very high cure rate. (author's)
Language: English
Keywords:
INDIA | RESEARCH REPORT | POSTPARTUM WOMEN | PREGNANCY | BLOOD COAGULATION EFFECTS | HEMATOLOGICAL EFFECTS | TREATMENT | Developing Countries | Asia, Southern | Asia | Puerperium | Reproduction | Hemic System | Physiology | Biology | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 298277

17.

Title: Protein Z and protein Z-dependent protease inhibitor. Determinants of levels and risk of venous thrombosis.
Author: Al-Shanqeeti A; van Hylckama Vlieg A; Berntorp E; Rosendaal FR; Broze GJ Jr
Source: Thrombosis and Haemostasis. 2005 Mar;93(3):411-3.
Abstract: To assess the potential roles of protein Z (PZ) and protein Z-dependent protease inhibitor (ZPI) in venous thrombosis, their plasma levels were measured in 426 individuals with venous thrombosis and 471 control individuals participating in the Leiden Thrombophilia Study. A relationship between the level of PZ or ZPI and venous thrombosis was not detected in the overall case-control study. PZ and ZPI circulate as a complex and their plasma levels are interdependent. Both PZ and ZPI are increased with oral contraceptive use and reduced with oral anticoagulant therapy.
Language: English
Keywords:
NETHERLANDS | RESEARCH REPORT | CONTROL GROUPS | CLIENTS | THROMBOSIS | RISK FACTORS | PROTEINS | BLOOD COAGULATION EFFECTS | ORAL CONTRACEPTIVES | Europe, Western | Europe | Developed Countries | Research Methodology | Program Activities | Programs | Organization and Administration | Thromboembolism | Embolism | Vascular Diseases | Diseases | Health | Physiology | Biology | Hematological Effects | Hemic System | Contraceptive Methods | Contraception | Family Planning
Document Number: 342800

18.
Title: Decreased plasma sensitivity to activated protein C by oral contraceptives is associated with decreases in plasma glucosylceramide.
Author: Deguchi H; Bouma BN; Middeldorp S; Lee YM; Griffin JH
Source: Journal of Thrombosis and Haemostasis. 2005 May;3(5):935-938.
Abstract: Oral contraceptive (OC) use increases venous thrombosis (VTE) risk and causes activated protein C (APC) resistance. Plasma glucosylceramide (GlcCer) deficiency is associated with VTE and GlcCer functions as an APC anticoagulant cofactor. Because estradiol decreases GlcCer in cultured cells, we hypothesized OC use would decrease plasma GlcCer and contribute to APC resistance. In a pilot study, seven female adults alternatively took second and third generation OCs and plasma samples were analyzed for GlcCer using high performance liquid chromatography and for APC sensitivity using modified prothrombin time assays. Second and third generation OC usage decreased the APC sensitivity ratio by 8.1% � 4.7% (P = 0.004) and 11.7% � 8.2% (P = 0.013) and plasma GlcCer levels by 10.1% � 6.8% (P = 0.008) and 11.0% � 5.1% (P = 0.002), respectively. The plasma GlcCer level correlated with the sensitivity of plasma to APC (P = 0.017, r = 0.51, n = 21 plasma samples). Thus, both second and third generation OC usage decreased plasma GlcCer which could cause a reduction in the plasma sensitivity to APC/protein S, thereby potentially increasing VTE risk. (author's)
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | PILOT PROJECTS | WOMEN | ORAL CONTRACEPTIVES, COMBINED | ADMINISTRATION AND DOSAGE | RISK FACTORS | THROMBOEMBOLISM | BLOOD COAGULATION EFFECTS | BLOOD PROTEINS | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Biology | Embolism | Vascular Diseases | Diseases | Hematological Effects | Hemic System | Physiology
Document Number: 286692

19.
Title: Pregnancy and oral contraceptives in factor V deficiency: a study of 22 patients (five homozygotes and 17 heterozygotes) and review of the literature.
Author: Girolami A; Scandellari R; Lombardi AM; Girolami B; Bortoletto E
Source: Haemophilia. 2005 Jan;11(1):26-30.
Abstract: Information on the effect of pregnancy or oral contraceptives (OC) in congenital factor V (FV) deficiency is scanty. The personal investigation of five homozygous and 17 female heterozygous showed that patients with severe deficiency bleed considerably at the time of delivery. However, bleeding can be controlled properly by administration of fresh frozen plasma with excellent foetal outcome. The safe level for adequate haemostasis seems around 25% of normal. On the contrary, heterozygote patients show no significant postpartum bleeding and therefore need no substitution therapy. Oral contraceptives were taken and well tolerated by four of our homozygous patients and appear to be beneficial because they cause a decrease in menometrorrhagies thereby improving the anaemia and decreasing transfusional needs. One patient took hormonal replacement therapy with no undue effects. No thrombosis was noted in the propositae during oral contraceptive therapy. The review of the literature has allowed the gathering of information on 20 additional pregnancies. The foetal outcome was satisfactory in every instance. Excessive bleeding was noted in 11 pregnancies. In seven of the remaining pregnancies, no undue bleeding was noted thanks to appropriate substitution therapy. In the remaining two pregnancies no bleeding was noted and no substitution therapy was given. No data are apparently available in the literature about the use of OCs in FV deficiency. (author's)
Language: English
Keywords:
ITALY | RESEARCH REPORT | CLINICAL TRIALS | LITERATURE REVIEW | WOMEN | PREGNANCY | ORAL CONTRACEPTIVES | THROMBOSIS | BLOOD COAGULATION EFFECTS | BLOOD TRANSFUSION | PREGNANCY COMPLICATIONS | PREGNANCY OUTCOMES | Europe, Southern | Europe | Developed Countries | Clinical Research | Research Methodology | Demographic Factors | Population | Reproduction | Contraceptive Methods | Contraception | Family Planning | Thromboembolism | Embolism | Vascular Diseases | Diseases | Hematological Effects | Hemic System | Physiology | Biology | Treatment
Document Number: 291553

20.

Title: Frequency of thrombophilia in patients with adverse pregnancy outcome.
Author: Hossain N; Shamsi T; Soomro N
Source: JPMA. Journal of the Pakistan Medical Association. 2005 Jun;55(6):245-247.
Abstract: The objective was to determine the association between adverse pregnancy outcomes and thrombophilia. This is a descriptive study, incorporating retrospective analysis of patients with recurrent pregnancy losses, intrauterine deaths, abruptio placenta and early onset pre eclampsia. Patients with adverse pregnancy outcomes in whom co-morbid factors were excluded underwent screening for both acquired and inherited thrombophilia. A total of 40 patients were screened for acquired and inherited thrombophilia with adverse pregnancy outcomes. Anticardiolipin antibodies were found positive in 55% of patients and 45% of patients were found deficient for natural anticoagulants protein C and S. Two patients were found positive for both acquired and inherited thrombophilia. Thrombophilia, both acquired and inherited are associated with adverse pregnancy outcomes. Patients in whom other co-morbid factors are excluded, should be offered screening for thrombophilia. Liaison between hematologist and obstetrician is the corner stone for success. (author's)
Language: English
Keywords:
PAKISTAN | RESEARCH REPORT | RETROSPECTIVE STUDIES | CLIENTS | THROMBOSIS | PREGNANCY COMPLICATIONS | PREECLAMPSIA | SCREENING | VASCULAR DISEASES | BLOOD COAGULATION EFFECTS | PROTEINS | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Thromboembolism | Embolism | Diseases | Examinations and Diagnoses | Hematological Effects | Hemic System | Physiology | Biology
Document Number: 289312

21.
Title: Bleeding disorders in teenagers presenting with menorrhagia.
Author: Jayasinghe Y; Moore P; Donath S; Campbell J; Monagle P
Source: Australian and New Zealand Journal of Obstetrics and Gynaecology. 2005 Oct;45(5):439-443.
Abstract: The objective was to assess the prevalence of bleeding disorders and establish the clinical variables that are predictive of a bleeding disorder in adolescent women. Design: A retrospective audit of all patients who had coagulation tests following presentation with menorrhagia. Setting: Inpatient and outpatients of a tertiary adolescent gynaecology service. Subjects aged 9-19 years with menorrhagia who had coagulation tests performed, and who did not have a known bleeding disorder prior to presentation were included. A bleeding screen was performed to assess prevalence of bleeding disorders in the population. Variables that were investigated as predictive of a bleeding disorder included clinical history, family history, and haematological indices of blood loss. The prevalence of an inherited bleeding disorder was 10.4%. The only statistically significant predictor was a family history of bruising and bleeding. Menstrual history was not predictive. Severity of menstrual loss was not predictive of a bleeding disorder, as a significant cause of teenage metrostaxis is due to anovulatory dysfunctional uterine bleeding. The authors recommend that a careful personal and family history of bruising and bleeding be taken in all teenagers who present de novo with menorrhagia. Routine screening in a primary care setting is impractical, but should be mandatory in all patients with a positive family history. (author's)
Language: English
Keywords:
AUSTRALIA | RESEARCH REPORT | RETROSPECTIVE STUDIES | ADOLESCENTS, FEMALE | AGE DISTRIBUTION | BLOOD COAGULATION EFFECTS | BLEEDING | MENSTRUATION DISORDERS | PREVALENCE | MENORRHAGIA | PROBABILITY | RISK ASSESSMENT | Developed Countries | Oceania | Studies | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Hematological Effects | Hemic System | Physiology | Biology | Signs and Symptoms | Diseases | Measurement | Statistical Studies | Evaluation
Document Number: 310361

22.
Peer Reviewed

Title: A 1-year study to compare the hemostatic effects of oral contraceptive containing 20 micrograms of ethinylestradiol and 100 micrograms of levonorgestrel with 30 micrograms of ethinylestradiol and 100 micrograms of levonorgestrel.
Author: Jespersen J; Endrikat J; D�sterberg B; Schmidt W; Gerlinger C
Source: Contraception. 2005;72:98-104.
Abstract: Objectives: To comparatively evaluate the impact of a balanced one- third dose-reduced oral contraceptive on hemostatic variables. Methods: In an open-label, randomized study, a dose-reduced oral contraceptive containing 20 �g of ethinylestradiol (EE) and 100 �g of levonorgestrel (LNG) was compared with a reference preparation containing 30 �g of EE and 150 �g of LNG. One-year data were obtained from 48 volunteers. Results: The direction and magnitude of the changes (increase or decrease) in most of the homeostatic variables were similar in both treatment groups. The majority of changes of all investigated variables remained within the reference ranges of variation. The procoagulatory variables increased to some extent from baseline to treatment cycle 13, while the anticoagulatory variables slightly decreased. In particular, thrombin turnover measured by prothrombin fragments 1+2 increased during treatment by 35% in the 20 �g of EE group and by 38% in the 30 �g of EE group. Statistically significant differences between the two treatment groups were found only for TAT. For the profibrinolytic variables, plasminogen was increased by 42% (20 �g of EE) and 49% (30 �g of EE). While the plasma levels of tPA antigen were reduced during treatment, the levels of its activity were increased by 54% (20 �g of EE) and 20% (30 �g of EE). For PAI, both antigen and activity were decreased, somewhat more pronounced with 20 �g of EE. D-Dimer remained virtually unchanged. Finally, the median FbDP levels were elevated by 30% (20 �g of EE) and 38% (30 �g of EE). (author's)
Language: English
Keywords:
DENMARK | RESEARCH REPORT | CLINICAL RESEARCH | COMPARATIVE STUDIES | WOMEN | HEMATOLOGICAL EFFECTS | ETHINYL ESTRADIOL | LEVONORGESTREL | PROSTAGLANDINS, ADMINISTRATION AND DOSAGE | ORAL CONTRACEPTIVES, COMBINED | ORAL CONTRACEPTIVES, LOW-DOSE | ANTIGENS | BLOOD COAGULATION EFFECTS | Developed Countries | Europe, Northern | Europe | Research Methodology | Studies | Demographic Factors | Population | Hemic System | Physiology | Biology | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Agents, Progestin | Prostaglandins | Endocrine System | Oral Contraceptives | Contraceptive Methods | Immunologic Factors | Immunity | Immune System
Document Number: 288310

23.
Title: Hemostatic status and fibrinolytic response potential at different phases of the menstrual cycle.
Author: Koh SC; Prasad RN; Fong YF
Source: Clinical and Applied Thrombosis / Hemostasis. 2005 Jul;11(3):295-301.
Abstract: Coagulation and fibrinolytic variables including platelet function and endogenous fibrinolytic response were determined in 30 normal healthy women volunteers not on any known medication during the period of study. They were between 18 years and 38 years old and had normal menstrual cycles of between 28 days and 30 days. Blood samples were obtained within one menstrual cycle and after having fasted overnight within days 1 to 3 (menstruation), 5 to 9 (follicular), 10 to 14 (mid-cycle), and 21 to 26 (luteal) of the menstrual cycle. Analysis of variance (ANOVA) showed no significant differences in the hemostatic parameters studied between the phases of the menstrual cycle except for a reduced D-dimer level at midcycle. Significant fibrinolytic response was seen after venous occlusion but they were not significantly different between the phases of the menstrual cycle. The women were then divided into either normal weight (n=22) or overweight (n=8) according to World Health Organization (WHO) classification and the data reanalyzed. Elevated tissue plasminogen activator antigen and plasminogen activator inhibitor-1 levels except at menstruation and total protein S except at follicular phase were observed in overweight women together with increased plasminogen level only at luteal phase. Significant endogenous fibrinolytic response seen during the menstrual cycle was not different between normal and overweight women. The study demonstrated that systemic coagulation, fibrinolysis, and platelet function were probably not influenced by natural hormonal changes occurring during the menstrual cycle except for an associated reduced fibrinolytic state at mid-cycle. The hemostatic system in this small group of healthy overweight women studied appeared to be physiologically compromised. (author's)
Language: English
Keywords:
SINGAPORE | RESEARCH REPORT | PROSPECTIVE STUDIES | WOMEN | FIBRINOLYSIS | BLOOD COAGULATION EFFECTS | MENSTRUAL CYCLE | BODY WEIGHT | HEMIC SYSTEM | Asia, Southeastern | Asia | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Hematological Effects | Physiology | Biology | Menstruation | Reproduction
Document Number: 285253

24.

Title: Use of recombinant factor VIIa for massive postpartum haemhorrage: case series and review of literature.
Author: Shamsi TS; Hossain N; Soomro N; Hasan JA; Noorani M
Source: JPMA. Journal of the Pakistan Medical Association. 2005 Nov;55(11):[3] p..
Abstract: Recombinant activated factor VII is indicated mainly for the treatment of patients with haemophilia inhibitors. It has also been found successful in the treatment of platelet disorder Glanzmann's thrombasthenia. Recently, its use in trauma patients and in patients with intracereberal haemorrhage has become well established. We present three cases of massive post partum haemorrhage treated with rFVIIa, following caesarean section. The response of these three patients is discussed along with review of literature. (author's)
Language: English
Keywords:
PAKISTAN | LITERATURE REVIEW | POSTPARTUM WOMEN | CESAREAN SECTION | POSTPARTUM | BLEEDING | BLOOD COAGULATION EFFECTS | BLOOD PROTEINS | TREATMENT | MATERNAL MORTALITY | Developing Countries | Asia, Southern | Asia | Puerperium | Reproduction | Obstetrical Surgery | Surgery | Signs and Symptoms | Diseases | Hematological Effects | Hemic System | Physiology | Biology | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 292908

25.
Title: Prothrombotic conditions, oral contraceptives, and the risk of ischemic stroke.
Author: Slooter AJ; Rosendaal FR; Tanis BC; Kemmeren JM; van der Graaf Y
Source: Journal of Thrombosis and Haemostasis. 2005 Jun;3(6):1213-1217.
Abstract: The role of inherited prothrombotic conditions, including factor V Leiden (FVG1691A), prothrombin G20210A, and the methylenetetrahydrofolate reductase (MTHFR) C677T genotype, in the pathogenesis of ischemic stroke is not well established. The effects of these factors may be potentiated by the use of oral contraceptives, analogous to observations in venous thrombosis. Patients (n = 193) were women aged 20-49 years with ischemic stroke. Controls (n = 767) were women without arterial thrombosis stratified for age, calendar year of the index event, and residence. The relative risk of ischemic stroke was estimated with unconditional logistic regression, adjusted for stratification variables. Factor V Leiden and MTHFR 677TT were more common in patients than in controls [odds ratio (OR): 1.8; 95% confidence interval (CI): 0.9-3.6 respectively OR: 1.5; 95% CI: 0.9-2.6]. The frequency of prothrombin G20210A was similar in cases and controls. Carriers of FV Leiden using oral contraceptives had a 11.2-fold (95% CI: 4.3- 29.0) higher risk of ischemic stroke than women without either risk factor. Women with MTHFR 677TT using oral contraceptives had a 5.4-fold (95% CI: 2.4-12.0) higher risk than women without these risk factors. These data suggest that carriers of FV Leiden or MTHFR 677TT who use oral contraceptives have an increased risk of ischemic stroke. When these findings are confirmed, a cost-effectiveness analysis should indicate whether ischemic stroke could be prevented with genetic testing before the start of oral contraceptives. (author's)
Language: English
Keywords:
NETHERLANDS | RESEARCH REPORT | CASE CONTROL STUDIES | WOMEN | CEREBROVASCULAR EFFECTS | ISCHEMIA | ORAL CONTRACEPTIVES, SIDE EFFECTS | TOBACCO USE | RISK FACTORS | GENETICS | BLOOD COAGULATION EFFECTS | Europe, Western | Europe | Developed Countries | Studies | Research Methodology | Demographic Factors | Population | Physiology | Biology | Vascular Diseases | Diseases | Contraceptive Safety | Safety | Public Health | Health | Behavior | Hematological Effects | Hemic System
Document Number: 287002

27.
Title: Changes in haemostasis during normal pregnancy.
Author: Uchikova EH; Ledjev II
Source: European Journal of Obstetrics, Gynecology and Reproductive Biology. 2005;119:185-188.
Abstract: The objectives were: (1) To study the changes in the haemostatic variables during normal pregnancy, and (2) to compare them with the corresponding variables in a control group of nonpregnant women. Setting: University Hospital. Subjects: The study involves two groups of women: pregnant women (in 35th�40th gestational weeks (GW)) (N = 35) and a control group of nonpregnant women (N = 35). We examined the global tests, the variables relating to coagulation and fibrinolysis and the group of natural inhibitors of coagulation, and compared them between the two groups. The pregnant women had statistically significantly higher values for: prothrombin time (PT) (P < 0.0001), thrombin time (TT) (P < 0.0001), fibrinogen (P < 0.0001), activity of factor VII (P < 0.0001), factor X (P < 0.0001) and alpha2-antiplasmin (P < 0.002), plasma concentration of D-dimer (plsDD) (P < 0.0001) and activity of heparin cofactor II (HCII) (P < 0.002). They had statistically significantly lower activity of protein C (PrC) (P < 0.0001) and of total protein S (TPrS) (P < 0.0001). During normal pregnancy the activation of coagulation is counterbalanced by the activation of fibrinolysis, which maintains the haemostatic balance. (author's)
Language: English
Keywords:
BULGARIA | RESEARCH REPORT | PREGNANT WOMEN | CONTROL GROUPS | PREGNANCY | RISK FACTORS | BLOOD COAGULATION EFFECTS | CHANGES | LABORATORY PROCEDURES | FIBRINOLYSIS | THROMBOSIS | Europe, Southeastern | Europe | Developing Countries | Population Characteristics | Demographic Factors | Population | Research Methodology | Reproduction | Biology | Hematological Effects | Hemic System | Physiology | Social Change | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Thromboembolism | Embolism | Vascular Diseases | Diseases
Document Number: 285472

28.
Title: Low-dose oral combination of 17beta-estradiol and norethisterone acetate in postmenopausal women decreases factor VII, fibrinogen, antithrombin and plasminogen activator inhibitor-1.
Author: Borgfeldt C; Li C; Samsioe G
Source: Climacteric. 2004 Mar;7(1):78-85.
Abstract: Objective Controversies still persist concerning hormone replacement therapy (HRT) and its effects upon blood coagulation and fibrinolysis. This study was carried out to evaluate possible effects of continuously administered low-dose 17�-estradiol (E2) and norethisterone acetate (NETA) on coagulation and fibrinolytic factors. Methods We conducted a randomized double-blind, placebo- controlled, 1-year study in 120 healthy postmenopausal women. The three groups consisted of a placebo group (n = 40), a group receiving oral continuous combined E2 1 mg and NETA 0.25 mg (n = 40) and a group receiving oral continuous combined E2 1 mg and NETA 0.5 mg (n = 40). Results The two low doses of E2-NETA induced significantly lower plasma levels of factor VII, fibrinogen, antithrombin and plasminogen activator inhibitor-1 (PAI-1), compared with placebo treatment. Conclusions Low-dose E2 (1 mg) in combination with NETA resulted in favorable changes of factor VII activity and fibrinogen, compared with placebo. The lower plasma levels of PAI-1 may lead to increased fibrinolytic activity. These findings suggest a decreased risk of developing coronary heart disease. Antithrombin activity was also reduced, which may increase the risk of developing venous thromboembolism. The clinical significance of the lower levels of these factors remains to be clarified. (author's)
Language: English
Keywords:
SWEDEN | RESEARCH REPORT | DOUBLE-BLIND STUDIES | WOMEN | MIDDLE AGED ADULTS | MENOPAUSE | ORAL CONTRACEPTIVES, COMBINED | HORMONE REPLACEMENT THERAPY | BLOOD COAGULATION EFFECTS | BLOOD PROTEINS | Developed Countries | Europe, Northern | Europe | Studies | Research Methodology | Demographic Factors | Population | Adults | Age Factors | Population Characteristics | Reproduction | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Treatment | Hematological Effects | Hemic System | Physiology | Biology
Document Number: 277962

29.
Peer Reviewed

Title: Severe acute maternal morbidity in rural South Africa.
Author: Gandhi MN; Welz T; Ronsmans C
Source: International Journal of Gynecology and Obstetrics. 2004 Nov;87(2):180-187.
Abstract: Our objective was to identify the frequency, causes, and avoidable factors of severe acute maternal morbidity (SAMM) in four non-specialist hospitals in rural South Africa. We conducted a prospective audit using criteria for SAMM suited to the diagnostic and treatment facilities available in the primary hospital setting. For each case of SAMM, a local audit team assessed the standard of care against local management guidelines and examined avoidable factors. An external specialist also retrospectively examined avoidable factors. The facility-based incidence of SAMM was 541 cases per 100,000 births (95% CI 368-767). The commonest organ systems involved were cerebral (42%), coagulation (19%), and vascular dysfunctions (16%). The commonest obstetric diagnoses were eclampsia (39%) and obstetric haemorrhage (32%). Approximately 65% of cases were avoidable. A qualitative case review audit of SAMM in a non-specialist rural setting appears feasible and sustainable, and provides valuable information towards improving deficiencies in maternal care. (author's)
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | RURAL POPULATION | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | PREGNANCY COMPLICATIONS | PREVALENCE | CEREBROVASCULAR EFFECTS | CARDIOVASCULAR EFFECTS | ECLAMPSIA | BLOOD COAGULATION EFFECTS | BLEEDING | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Diseases | Measurement | Physiology | Biology | Hematological Effects | Hemic System | Signs and Symptoms
Document Number: 276340

30.
Title: Pregnancies and oral contraceptive therapy in severe (homozygons) FXII deficiency: a study in 12 patients and review of the literature.
Author: Girolami A; Zocca N; Girolami B; Lombardi AM; Fabris F
Source: Journal of Thrombosis and Thrombolysis. 2004 Dec;18(3):209-212.
Abstract: Twelve women with severe Factor XII (FXII) deficiency were under observation for an average period of about 16 years. During this time, these women had 19 pregnancies without any bleeding or thrombotic complications. The evaluation of the literature has shown that three patients manifested deep vein thrombosis during pregnancy. Five women also showed mild bleeding at delivery. The significance of these findings is not clear since thrombotic and bleeding complications may occur occasionally even in normal women. Five of our patients took oral contraceptive therapy during their fertile life for a variable period of time (2-10 years). No thombosis was noted in any of these patients. From the scanty data gathered, in this respect, from the literature, it was shown that only three women with severe FXII deficiency took oral contraceptives and no thrombosis was noted. Altogether these results seem to indicate that the FXII deficiency does not play any significant role in the pathogenesis of bleeding and of thrombotic complications in pregnancy. However, the occurrence of deep vein thrombosis in 3 out of the 64 patients for whom sufficient data could be gathered indicates the need for further studies. This is more so if one considers that 3 out of the 6 cases of venous thromboses described altogether in the literature for females with severe FXII deficiency occurred during pregnancy or puerperium. (author's)
Language: English
Keywords:
ITALY | RESEARCH REPORT | CLINICAL TRIALS | LITERATURE REVIEW | WOMEN | PREGNANCY | ORAL CONTRACEPTIVES | THROMBOSIS | BLOOD COAGULATION EFFECTS | ANTIGENS | PREGNANCY COMPLICATIONS | LABORATORY EXAMINATIONS AND DIAGNOSES | Europe, Southern | Europe | Developed Countries | Clinical Research | Research Methodology | Demographic Factors | Population | Reproduction | Contraceptive Methods | Contraception | Family Planning | Thromboembolism | Embolism | Vascular Diseases | Diseases | Hematological Effects | Hemic System | Physiology | Biology | Immunologic Factors | Immunity | Immune System | Examinations and Diagnoses
Document Number: 291552


	Information & Knowledge for Optimal Health (INFO) Project 111 Market Place Suite 310, Baltimore, MD 21202 Phone: 410-659-6300 Fax: 410-659-6266 Security & Privacy Policy