Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the case of cardiac patients, the disease often imposes the necessity for extreme care in preventing possible pregnancy. Condoms or diaphragms are effective but often poorly accepted by the patients. IUDs are also effective but contraindicated because they increase genital hemorrhage especially in patients being treated with an anticoagulant, for it can lead to chronic anemia, and it increases the possibility of genital infection. Tubal sterilization is a possibility after laparotomy or by vaginal entry but coelioscopy is dangerous for some cardiac patients. Also the same factors that relate to healthy women must be considered before sterilization: age, number of children, and psychological stability. The use of estroprogestins is also risky because the estrogen causes a hydrosodium retention and several other changes in body chemistry which may be dangerous for them. The risk of phlebitis and of pulmonary embolism is multiplied by 10, of cerebral infarction by 9, and of myocardial infarction by 3 to 4. If the decision is made to try them, the arterial tension must be measured regularly. Progesterones alone have less influence on coagulation, but still present the risks of thrombosis. Minipills avoid many of the problems encountered with regular doses but can provoke intermenstrual hemorrhage. The use of pure progestin in a small dose (e.g., lynestrenol .5 mg) is being studied because it appears to have the advantages of being easily accepted and without serious side effects.
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PMID:[Contraception in female cardiac patients]. 89 11

This second part of a two-part article on contraceptive methods discusses indications and criteria for choice of methods, with reference especially to developing countries. The practitioner should spend some time at the first contraceptive consultation explaining the methods to the user and determining their acceptability. Contraindications for oral contraceptives (OCs) and IUDs should first be ruled out. The significant contraindications to OC use include hypertension, phlebitis or pulmonary embolism, diabetes and hypercholesterolemia, family history of uterine or breast cancer, and smoking. Pregnancy, nulliparity, history of genital infection, and inability to assure regular follow-up are contraindications to IUD use. The side effects of the different methods should be kept in mind because they may discourage users. The preferences of the individual or couple are often founded on subjective factors, and cultural, religious, or customary factors in the community may influence the overall demand for each method. The marital status, frequency of sexual relations, stage of family formation, number of partners, and stability of individuals or couples should also be considered in choosing a method. A preliminary medical consultation is always advisable before contraceptive use begins, if only to inform users about the risks of sexually transmitted diseases. Contraceptives should be of low cost and financially accessible so that potential users, perhaps not strongly motivated, will not be discouraged by cost considerations. Re-supply of the selected method should be regular and assured. The contraceptive decision may be guided by a protocol or standardized strategy, similar to a protocol of diagnosis and treatment. If such protocols are developed, carefully supervised nurses or midwives may carry out some of the work.
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PMID:[Contraceptive methods: 2. Indications and suggestions for a choice]. 1229 18