Prevention of thromboembolic complications in hormonal contraception in women over 35 years

Kutsenko I.I., Tomina O.V., Borovikov I.O., Savchenko T.N.

1 Kuban State Medical University, Krasnodar, Ministry of Health of Russia, Krasnodar 350063, М. Sedina street, 4; 2 N.I. Pirogov Russian National Research Medical University, Moscow 125367, Ivankovskoe highway, 7, Russia
Objective. To assess the effects of combined oral contraceptives that contain micronized ethinylestradiol (20 mg) and drospirenone (3 mg) in combination with dipyridamole (75 mg) for indicators of hemostasis in women older than 35 years.
Subjects and methods. Research of the hemostasis system with the use of combined oral contraceptives (90 healthy women 36-45 years): Group I (45 patients) – have received COC in combination with dipyridamole; Group II (45 patients) – only COC. Used: APTT, prothrombin test, Thrombin time, Fibrinogen concentration, activity of factor VIII, activity of antithrombin, resistance to activated protein c.
Results. In the second group was not increase prothrombin ratio determination test and level of Antithrombin found in patients in Group I, group II also increased the activity of factor VIII from the original target and activity antithrombin declined (in Group I it had downward trend). In addition, in the II group index Ars-resistance through 6 and 12 months was below both the source data and the limits of normal values.
Conclusion. Application of combined oral contraceptives does not cause clinically significant changes of the hemostatic system, but the combination of the COC, together with dipyridamole helps reduce thrombophilia impact of hormonal contraceptives.

Keywords

Combined oral contraception
embolic complications
dipiridamol

Supplementary Materials

  1. Table 1. Indicators of coagulogram in the study groups (M ± m)
  2. Table 2. The index of resistance to activated protein in the study groups (M ± m)

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Received 13.10.2017

Accepted 27.10.2017

About the Authors

Kutsenko Irina I., MD, Professor, Head of Department of Obstetrics and Gynecology, Kuban State Medical University, Ministry of Health of Russia.
350063, Russia, Krasnodar, Sedina str. 4
Tomina Oksana V., MD, PhD, Department of Obstetrics and Gynecology, Kuban State Medical University, Ministry of Health of Russia.
350063, Russia, Krasnodar, Sedina str. 4. E-mail: bio2302@gmail.com
Borovikov Igor O., MD, PhD, Department of Obstetrics and Gynecology, Kuban State Medical University, Ministry of Health of Russia.
350063, Russia, Krasnodar, Sedina str. 4. E-mail: bio2302@gmail.com
Savchenko Tatyana N., MD, Professor of the Department of Obstetrics and Gynecology of the Faculty of Physiotherapy, N.I. Pirogov Russian National Research Medical University. 125367, Russia, Moscow, Ivankovskoe highway, 7. E-mail: 12111944t@mail.ru

For citations: Kutsenko I.I., Tomina O.V., Borovikov I.O., Savchenko T.N. Prevention of thromboembolic complications in hormonal contraception in women over 35 years. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (12): 136-40. (in Russian)
https://dx.doi.org/10.18565/aig.2017.12.136-140

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