Venous thromboembolism associated with combined oral contraceptive use: a single-institution experience
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ObjectiveCombined oral contraceptives (COCs) are used for various reasons. However, venous thromboembolism (VTE), asignificant side effect, can be fatal. This study reports the first case series in Korea involving patients with COCassociatedVTE registered at a university hospital. MethodsThis study recruited 13 patients diagnosed with COC-associated VTE between June 2006 and May 2018. Risk factors,including age, body mass index, smoking habits, estrogen dosage, type of progestin, and duration of COC use, wereevaluated. ResultsAmong patients with VTE, 9 showed pulmonary embolism (PE) concomitant with deep vein thrombosis (DVT). However, the remaining patients showed DVT (1 patient), PE (1 patient), and cerebral venous thrombosis (2 patients). The median duration between the onset of symptoms and a hospital visit was 3 days, and it sometimes took as longas 32 days. Among the 10 patients with PE, 1 high-risk group and 2 intermediate-high risk groups were treatedwith tissue plasminogen activators before anticoagulants. There were no cases of recurrence among patients whocontinued to take anticoagulants for 3 months. ConclusionThese findings emphasize that healthcare professionals who prescribe or dispense COCs to women must inform themof the risk of VTE, including the risk factors, differences in risk depending on the type of progestin present in theproduct, and pertinent signs and symptoms. Efforts should also be made to inform patients of VTE, even throughinformation campaigns such as brochures. Most importantly, women should remain alert for signs and symptoms ofVTE when using COCs.
Abstract
ObjectiveCombined oral contraceptives (COCs) are used for various reasons. However, venous thromboembolism (VTE), asignificant side effect, can be fatal. This study reports the first case series in Korea involving patients with COCassociatedVTE registered at a university hospital. MethodsThis study recruited 13 patients diagnosed with COC-associated VTE between June 2006 and May 2018. Risk factors,including age, body mass index, smoking habits, estrogen dosage, type of progestin, and duration of COC use, wereevaluated. ResultsAmong patients with VTE, 9 showed pulmonary embolism (PE) concomitant with deep vein thrombosis (DVT). However, the remaining patients showed DVT (1 patient), PE (1 patient), and cerebral venous thrombosis (2 patients). The median duration between the onset of symptoms and a hospital visit was 3 days, and it sometimes took as longas 32 days. Among the 10 patients with PE, 1 high-risk group and 2 intermediate-high risk groups were treatedwith tissue plasminogen activators before anticoagulants. There were no cases of recurrence among patients whocontinued to take anticoagulants for 3 months. ConclusionThese findings emphasize that healthcare professionals who prescribe or dispense COCs to women must inform themof the risk of VTE, including the risk factors, differences in risk depending on the type of progestin present in theproduct, and pertinent signs and symptoms. Efforts should also be made to inform patients of VTE, even throughinformation campaigns such as brochures. Most importantly, women should remain alert for signs and symptoms ofVTE when using COCs.
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