Contraception (Birth Control) and Family Planning PubHealthInfo

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PubHealth.info® (a subsidiary of PakMed) presents scientific information mainly based on abstracts of articles published on a variety of public health issues/topics, particularly encompassing population planning, disease prevention, maternal and child health, and communicable and non-communicable diseases (like HIV AIDS, malaria, etc) that are affecting a significant portion of population in developing and developed countries. Here you can find abstracts of articles published on a variety of public health topics under category "Contraception (Birth Control) and Family Planning". Contraception (birth control) is a regimen of one or more actions, devices, or medications followed in order to deliberately prevent or reduce the likelihood of a woman becoming pregnant or giving birth. Therefore contraception is the utilization of various and sundry surgical procedures, devices, practices, agents, or drugs with the intention of preventing conception or impregnation (pregnancy). Methods and intentions typically termed birth control may be considered a pivotal ingredient to family planning. Birth control is a controversial political and ethical issue in many cultures and religions, and although it is generally less controversial than abortion specifically.

YEAR: 1983

CATEGORY: Contraception (Birth Control) and Family Planning

TITLE

Oral contraceptives and von Willebrand's disease [letter]

AUTHORS

Mangal AK; Naiman SC

SOURCE

CMAJ: Canadian Medical Association Journal. 1983 Jun 1;128(11):1274.

ABSTRACT

Oral contraceptives (OCs) are not uncommonly used to treat menorrhagia. Von Willebrand's disease is a frequent

bleeding disorder; however, it is difficult to diagnose because of its variable nature. We report on a patient with mild

von Willebrand's disease in whom the diagnosis was masked by the OC she was taking. A young woman, first seen

at age 17 years, had severe menorrhagia requiring admission to hospital and blood transfusions on 6 occasions.

OCs were prescribed after no gynecologic cause for her bleeding was discovered. She was referred to a

hematologist for investigation of a possible bleeding disorder. Screening coagulation studies, including

measurement of the partial thromboplastin time and platelet aggregation studies, all had normal results. Her

bleeding time, however, was borderline, and the platelet adhesiveness was decreased, at 10% (normally 20%-60%).

More sophisticated studies were not available. It was suggested that the patient stop taking the OC and return in 1

month. Nothing further was heard from the patient until she was 27 years old and presented for preoperative

assessment. She gave a history of menorrhagia of 9 months' duration after she stopped taking the OC. The partial

thromboplastin time was still normal, but the bleeding time was prolonged; in addition, the factor 8 activity was 60%

of normal, the level of the ristocetin cofactor (von Willebrand's factor) 17% of that in normal pooled plasma (normally

more than 50%) and the level of factor 8 antigen 36 U/dl (normally more than 50 U/dl). All these results were

consistent with the diagnosis of mild von Willebrand's disease. Clearly the OC masked the diagnosis of von

Willebrand's disease in this patient. The contraceptive also controlled her bleeding symptoms well, so that the

patient was "lost" to follow-up for 9 years. A bleeding disorder would not have been suspected, and hence the

diagnosis of von Willebrand's disease would have been missed, if this patient had not stopped taking the OC and

had not been reinvestigated. It is likely that many similar patients are treated for menorrhagia without having the

diagnosis of von Willebrand's disease established, so that the incidence of this disease in the general population is

falsely low. (PubHealth.info Document ID: CONT5T 2073-06)

PubHealth.info NOTE: The author(s) of this article titled, "Oral contraceptives and von Willebrand's disease [letter]",

is(are) Mangal AK; Naiman SC. The source of this article is "CMAJ: Canadian Medical Association Journal. 1983

Jun 1;128(11):1274.". This article was published in 1983 in English language(s). (PubHealth.info® Document ID:

CONT5T 2073-06. All rights reserved with PubHealth.info) PIN: 22073

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