By Rebecca H. Allen, Carrie A. Cwiak
Women with persistent clinical difficulties are at larger danger for problems while pregnant and for that reason, they're in particular short of acceptable preconception and birth control care. in addition, many ladies with power clinical difficulties don't receive sufficient preconception and birth control care. regardless of released guidance by means of the facilities for disorder keep an eye on and Prevention, there's a gigantic hole in clinical perform concerning the use of birth control in ladies with co-existing scientific problems.
Contraception for the Medically hard Patient fills the space that presently exists within the wisdom of right contraceptive prescribing perform and exhibits that beside the point contraindications can simply develop into a barrier to powerful birth control use between ladies. Chapters spotlight out of date perspectives approximately acceptable applicants for birth control and deal with the complicated contraceptive wishes of contemporary medically not easy sufferers with HIV/AIDS, uterine fibroids or cardiac, neurologic or thyroid ailment. The publication offers realization to tips on using birth control in girls with scientific difficulties comparable to diabetes, weight problems, epilepsy, and lupus, between others and gives finished information about the consequences that yes medicines could have on contraceptive hormone degrees. whereas nationwide directions do exist for contraceptive eligibility, this e-book discusses in additional aspect the facts at the back of the rule of thumb suggestions and the nuances that clinicians confront in day-by-day practice.
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Additional resources for Contraception for the Medically Challenging Patient
Sample text
Hov GG, Skjeldestad FE, Hilstad T. Use of IUD and subsequent fertility–follow-up after participation in a randomized clinical trial. Contraception. 2007;75(2):88–92. 23. Mishell Jr DR. Pharmacokinetics of depot medroxyprogesterone acetate contraception. J Reprod Med. 1996;41(5 Suppl):381–90. 24. Schwallie PC, Assenzo JR. Contraceptive use—efficacy study utilizing medroxyprogesterone acetate administered as an intramuscular injection once every 90 days. Fertil Steril. 1973;24(5):331–9. 25. ACOG.
For this reason, the international normalized ratio (INR) in women concurrently on warfarin therapy and any hormonal contraception should be closely monitored. Second, depot medroxyprogesterone acetate (DMPA) use in anticoagulated women carries with it a theoretical risk for hematoma 2 Contraceptive Management of Women with Cardiac Disease formation at the intramuscular (IM) injection site [35]. To our knowledge, no studies have been published on the safety of intramuscular DMPA injections in anticoagulated women that specifically look at the concern for bleeding at the injection site.
However, the IUD and contraceptive implant are highly cost-effective after just 1 year of use [20, 21]. All women should be assured that these methods can easily be removed at any time for any reason, with rapid return to fertility [22]. In fact, all contraceptive methods have a rapid return to fertility except for DMPA, which has a mean return to ovulation of 10 months [23, 24]. Thus, an individual’s possible desire for pregnancy within 1 year should not preclude the use of these LARC methods, especially for women with medical comorbidities.
