Contraception in medical conditions
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Transcript of Contraception in medical conditions
By: Dr Harris Roland
O&G Specialist of SGH
Conditions COCP/POP DMPA IMP Cu-IUD LNG-IUS
Controlled HPT 3/1 2 1 1 1
SBP: > 140 – 159DBP: >90 - 94
3/1 1 1 1 1
SBP: > 160DBP: > 95
4/1 2 1 1 1
Vascular Disease 4/2 3 2 1 1
Hormonal Therapy Effect on Glucose Metabolism
Estrogen NO EFFECT
Progestogen INCREASE INSULIN RESISTANCE
DMPA INCREASE INSULIN RESISTANCE
Progestogen Implants MINIMAL EFFECT
Conditions COCP/POP DMPA IMP Cu-IUD LNG-IUS
History of GDM 1/1 1 1 1 1
Non-Vascular Disease:
a) NIDDM2/2 2 2 1 2
b) IDDM 2/2 2 2 1 2
NephropathyRetinopathyNeuropathy
3/2 3 2 1 2
Other vascular disease 3/2 3 2 1 2
Conditions COCP/POP DMPA IMP Cu-IUD LNG-IUS
Certain Anti-convulsant
• Phenytoin• Carbamazepine• Barbiturate• Primidone
3/1 1 1 1 1
Lamotrigine 3/1 1 1 1 1
Conditions COCP/POP DMPA IMP Cu-IUD LNG-IUS
Smoking :
Age < 35 years 2/1 1 1 1 1
Age > 35 years
a) 15 Cigarettes/day 3/1 1 1 1 1
b) > 15 Cigarettes/day 4/1 1 1 1 1
c) Quit < 1 year 3/1 1 1 1 1
d) Quit > 1 year 2/1 1 1 1 1
Conditions COCP/POP DMPA IMP Cu-IUD LNG-IUS
High Risk for HIV 1 1 1 1 1
HIV Infected:
a) Not using ART 1 1 1 2 2
b) Using ART 1-3 1-2 1-2 2-3 2-3
AIDS on ART 2 2 2 2 2
Conditions COCP/POP DMPA IMP Cu-IUD LNG-IUS
ThrombogenicMutation
Factor V-Leiden 4/2 2 2 1 2
Prothombin mutation 4/2 2 2 1 2
Protein C/S Deficiency 4/2 2 2 1 2
Antithrombin Deficiency 4/2 2 2 1 2
Superficial Venous Thrombosis
Varicose Vein 1/1 1 1 1 1
Sup. Thrombophlebitis 2/1 1 1 1 1
Conditions COCP/POP DMPA IMP Cu-IUD LNG-IUS
VTE
a) History of VTE 4/2 2 2 1 2
b) Current VTE 4/2 2 2 1 2
c) Family history of VTE 3/1 1 1 1 1
d) Major Surgery
Mobilization (PI) 4/2 2/1 2/1 1/1 2/1
Mobilization (WO) 2/1
e) Minor Surgery
Mobilization (PI) 3/1 1/1 1/1 1/1 1/1
Mobilization (WO) 1/1
Conditions COCP/POP DMPA IMP Cu-IUD LNG-IUS
SLE
a) Positive APS 4/3 3 3 1 3
b) Thrombocytopenia 2/2 3 2 3 2
c) Immun0suppressivetreatment
2/2 2 2 1 2
d) Uncomplicated SLE 2/2 2 2 1 2
Conditions COCP/POP DMPA IMP Cu-IUD LNG-IUS
PID
a) Past history of PID 1/1 1 1 1 1
b) Current PID 1/1 1 1 4/2 4/2
c) Chlamydia Infection 1/1 1 1 4/2 4/2
d) Gonorrhea 1/1 1 1 4/2 4/2
e) Vaginitis(Trichomonas) 1/1 1 1 2/2 2/2