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Rivista di Ostetricia e Ginecologia
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index
Minerva Ginecologica 2017 June;69(3):259-68
Copyright © 2017 EDIZIONI MINERVA MEDICA
Contraception for women with heart disease: an update
Rogério BONASSI MACHADO 1 ✉, Ana C. GANDOLPHO 1, Narayana SANTANA 1, Rogerio C. BOCARDO 1, Nathalia PALANDRI 1, Renato MORASSUTTI MACHADO 2
1 Department of Gynecology and Obstetrics, Jundiaí Medical School, Jundiaí, São Paulo, Brazil; 2 University of Sao Caetano do Sul, Faculty of Medicine, São Paulo, Brazil
BACKGROUND: It is estimated that by the year 2013, 303.000 women worldwide died as a result of pregnancy-related conditions. The risk of pregnancy complications in women with heart disease depends on the specific disease and on the individual conditions of each patient.
EVIDENCE ACQUISITION: A bibliographic research was carried out on PubMed using the descriptors “heart disease” AND “contraceptive” OR “pregnancy” AND “thrombosis” OR “angina” OR “cardiopathy”. A total of 1456 articles were found.
EVIDENCE SYNTHESIS: Classification of heart disease in pregnancy according to the severity of the condition include high, intermediate or low-risk cardiac patients. Tubal ligation is indicated for women with high-risk heart disease. Reversible methods are possible for intermediate or low-risk cardiac patient, but formal contraindications for estrogens are present in large percentage of clinical conditions and progestogen-only formulations are generally considered. Contraindications to the use of an intrauterine device disease should be considered.
CONCLUSIONS: According to the different forms of heart disease, different contraceptive methods are recommended.
KEY WORDS: Contraception - Contraceptives, oral, combined - Heart diseases - Heart diseases, congenital