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


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


Certain Anti-convulsant

• Phenytoin• Carbamazepine• Barbiturate• Primidone

3/1 1 1 1 1

Lamotrigine 3/1 1 1 1 1


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


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


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


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


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


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

contraception in medical conditions

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