Home >> Gynaecology >> ForumTopic: Contraceptives
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| superbdoc Total Posts: 273 | Posted: Tue Oct 14, 2008 07:39 pm Which one of the following is the ideal contraceptive for a patient with heart disease ? A) IUCD B) Depoprovera C) Diaphragm D) Oral contraceptive pills |
| juhidr Total Posts: 149 | Posted: Wed Oct 15, 2008 12:04 am Contraindications of Different Methods A - IUCD Conditions where insertion of a copper should not be inserted - - Postpartum between 48 hours and 4 weeks (increased IUD expulsion rate with delayed postpartum insertion) - Benign gestational trophoblastic disease - Ovarian cancer - Very high individual likelihood of exposure to gonorrhea or chlamydial STIs - AIDS (unless clinically well on anti-retroviral therapy) - Pregnancy - Postpartum puerperal sepsis - Immediately post-septic abortion - Before evaluation of unexplained vaginal bleeding suspected of being a serious condition - Malignant gestational trophoblastic disease - Cervical cancer (awaiting treatment) - Endometrial cancer - Distortions of the uterine cavity by uterine fibroids or anatomical abnormalities - Current PID - Current purulent cervicitis, chlamydial infection, or gonorrheal STIs - Known pelvic tuberculosis B- Depo Provera Conditions where the theoretical or proven risks usually outweigh the advantages of using Depo-Provera: * Multiple risk factors for arterial cardiovascular disease * Current deep vein thrombosis (DVT) or pulmonary embolus (PE) * Migraine headache with aura while using Depo-Provera * Before evaluation of unexplained vaginal bleeding suspected of being a serious condition * Past history of breast cancer and no evidence of current disease for 5 years * Active liver disease: (acute viral hepatitis, severe decompensated cirrhosis, benign or malignant liver tumours) * Conditions of concern for hypo-estrogenic effects and reduced HDL levels theoretically increasing cardiovascular risk: o Hypertension with vascular disease o Current and history of ischemic heart disease o History of stroke o Diabetes for over 20 years or with nephropathy/retinopathy/neuropathy or vascular disease C- Diaphragm - Should not be used in Allergy to latex - UTI risk is increased - Toxic shock syndrome (TSS) almost exclusively when the device is left in place longer than 24 hours D- Oral Contraceptive Pills Side effects associated with low-dose COCPs are - Leukorrhea - Reductions in menstrual flow - Mastalgia - Increase in breast size - Decrease in acne Side effects associated with older high-dose COCPs include - - nausea - vomiting - increases in blood pressure - melasma So, IUCD seems to be the best answer |
| superbdoc Total Posts: 273 | Posted: Wed Oct 15, 2008 01:11 am But I had confusion b/w barrier and Depoprovera....Ans acc to 2day's key is Barrier...  |
| juhidr Total Posts: 149 | Posted: Wed Oct 15, 2008 02:03 am barrier is an equally good option (hmmmm... will check and report later) |
| jemzcal Total Posts: 127 | Posted: Wed Oct 15, 2008 02:19 am I am in favour of barrier method as far as the above q is concerned |
| juhidr Total Posts: 149 | Posted: Wed Oct 15, 2008 02:25 am i respect your opinion, it has an equally good chance. Will try to sort it out very soon. |
| jemzcal Total Posts: 127 | Posted: Thu Oct 16, 2008 06:27 pm contraception in heart disease for a family completed person sterlisation for a young couple barrier ** what is the contraceptive of choice in a patient with sickle cell disease? |
| superbdoc Total Posts: 273 | Posted: Thu Oct 16, 2008 07:59 pm Prescribing Guidelines "Women with sickle cell disease and their fetuses are at high risk of complications. Therefore, highly effective contraception is desirable. The World Health Organization gives sickle cell disease a "2" rating - means that, in general, the benefits from the use of oral contraceptives generally outweigh the risks for women with the disease. Other choices include injectables and implants or sterilization. Some clinicians consider injectable contraception the first choice for women with sickle cell disease; however, women who cannot or do not wish to use DMPA or other methods of birth control should be given the choice to use OCs." This is what I got from net....I think there's a consensus that OCPs may be given.... But I am confused if its the contraceptive OF CHOICE...  |
| jemzcal Total Posts: 127 | Posted: Thu Oct 16, 2008 08:41 pm nice try superbdoc. The answer is DMPA.. It has got some anti sickling activity. i agree with you in the usage of OCPs if the q was what is the usual mode of contraception given to persons with sickle cell disease.  |