CONSENSO SOBRE CONTRACEÇÃO 2020

Contraceção Hormonal e Intrauterina com Condições Médicas Especiais | DOENÇAS AUTO-IMUNES E VASCULARES | D1
Alterações venosas superficiais
A presença de veias varicosas não é fator de risco para TEV/EP. Todos os contracetivos são elegíveis 1-5 .
Um estudo demonstra a associação entre a trombose venosa superficial e o risco aumentado de TEV nas utilizadoras de CHC
quando comparadas com as não utilizadoras 23 .
Na presença de fatores de risco concomitantes para TEV (trombofilia, doença oncológica) ou história de TEV agudo ou antecedentes
de TEV ver recomendações para o uso de contraceção e TEV/EP. A trombose venosa superficial associada a um cateter
periférico está fracamente associada a TEV e o uso de CHC deve ser ponderado.
BIBLIOGRAFIA
1. WHO. Medical eligibility criteria for contraceptive use. WHO (2015).
2. Curtis, K. M. et al. U.S. Medical Eligibility Criteria for Contraceptive Use,
2016. MMWR. Recommendations and reports : Morbidity and mortality
weekly report. Recommendations and reports / Centers for Disease
Control 65, (2016).
3. Culwell, K. R. IPPF Medical Bulletin New recommendations for.
Obesity 44, 1–5 (2010).
4. ACOG. ACOG Practice Bulletin No. 206 Summary: Use of Hormonal
Contraception in Women With Coexisting Medical Conditions. Obstetrics
& Gynecology 133, 396–399 (2019).
5. Faculty of Sexual & Reproductive Healthcare. Uk Medical Eligibility
Criteria. (2016).
6. Sammaritano, L. R. Contraception in Patients with Rheumatic Disease.
Rheumatic Disease Clinics of North America 43, 173–188 (2017).
7. Sammaritano, L. R. Contraception in patients with systemic lupus
erythematosus and antiphospholipid syndrome. Lupus 23, 1242–1245
(2014).
8. Gensous, N., Doassans-Comby, L., Lazaro, E. & Duffau, P. Lupus
érythémateux systémique et contraception : revue systématique de
la littérature. Revue de Medecine Interne 38, 358–367 (2017).
9. Sánchez-Guerrero, J. et al. A trial of contraceptive methods in
women with systemic lupus erythematosus. The New England journal
of medicine 353, 2539–49 (2005).
10. Pisoni, C. N., Cuadrado, M. J., Khamashta, M. A. & Hunt, B. J. Treatment
of menorrhagia associated with oral anticoagulation: Efficacy
and safety of the levonorgestrel releasing intrauterine device (Mirena
coil). Lupus15, 877–880 (2006).
11. Andreoli, L. et al. EULAR recommendations for women’s health
and the management of family planning, assisted reproduction,
pregnancy and menopause in patients with systemic lupus erythematosus
and/or antiphospholipid syndrome. Annals of the Rheumatic
Diseases 76, 476–485 (2017).
12. Farr, S. L., Folger, S. G., Paulen, M. E. & Curtis, K. M. Safety of
contraceptive methods for women with rheumatoid arthritis: a systematic
review. Contraception 82, 64–71 (2010).
13. Wibetoe, G. et al. Cardiovascular disease risk profiles in inflammatory
joint disease entities. Arthritis Research & Therapy 19, 153 (2017).
14. Radner, H., Lesperance, T., Accortt, N. A. & Solomon, D. H. Incidence
and Prevalence of Cardiovascular Risk Factors Among Patients
With Rheumatoid Arthritis, Psoriasis, or Psoriatic Arthritis. Arthritis
care & research 69, 1510–1518 (2017).
15. van Vlijmen, E. F. W., Wiewel-Verschueren, S., Monster, T. B. M. &
Meijer, K. Combined oral contraceptives, thrombophilia and the risk
of venous thromboembolism: a systematic review and meta-analysis.
Journal of Thrombosis and Haemostasis 14, 1393–1403 (2016).
16. van Vlijmen, E. F. W. et al. Thrombotic risk during oral contraceptive
use and pregnancy in women with factor V Leiden or prothrombin
mutation: a rational approach to contraception. Blood 118,
2055–61; quiz 2375 (2011).
17. Wu, O. et al. Screening for thrombophilia in high-risk situations:
a meta-analysis and cost-effectiveness analysis. British journal of
haematology 131, 80–90 (2005).
18. Grody, W. W., Griffin, J. H., Taylor, A. K., Korf, B. R. & Heit, J. A.
American College of Medical Genetics Consensus Statement on Factor
V Leiden Mutation Testing. Genetics in Medicine 3, 139–148 (2001).
19. Schaedel, Z. E., Dolan, G. & Powell, M. C. The use of the levonorgestrel-releasing
intrauterine system in the management of
menorrhagia in women with hemostatic disorders. American journal
of obstetrics and gynecology 193, 1361–3 (2005).
20. Gray, B., Floyd, S. & James, A. H. Contraceptive Management for
Women Who Are at High Risk of Thrombosis. Clinical Obstetrics and
Gynecology 61, 243–249 (2018).
21. Tepper, N. K., Whiteman, M. K., Marchbanks, P. A., James, A. H. &
Curtis, K. M. Progestin-only contraception and thromboembolism: A
systematic review. Contraception 94, 678–700 (2016).
22. Braga, G. C. et al. Oral anticoagulant therapy does not modify
the bleeding pattern associated with the levonorgestrel-releasing
intrauterine system in women with thrombophilia and/or a history
of thrombosis. Contraception 89, 48–53 (2014).
23. epper, N. K., Marchbanks, P. A. & Curtis, K. M. Superficial venous
disease and combined hormonal contraceptives: a systematic review.
Contraception 94, 275–279 (2016).
83