[Contraceptive use in women with heart disease].
OBJECTIVE
To analyse efficacy, tolerance and adverse events of reversible contraceptives in women with cardiac disease.


METHODS
We studied prospectively during 24-39 (mean = 29) months, 89 women with heart disease with a mean age of 25.6 (16-42) years. Rheumatic heart disease was present in 73 (82%) cases, congenital heart disease in 11 (11%), coronary artery disease in 2 (2%) and cardiomyopathy in 3 (3%) case. The patients were divided in three groups: GCO--35 patients taking combined oral contraceptives (30 micrograms ethinyl estradiol and 75 micrograms gestodene--COs); GIT--27 using injectable progestagens (depot medroxyprogesterone acetate-DMPA) and GUID--27 with intrauterine device (IUD).


RESULTS
In GCO occurred 4 (11.4%) cases of arterial hypertension, 1 (2.8%) of a transient cerebral isquemic attack, 3 (8.5%) of spotting, 1 (2.8%) of amnorrhea e 1 (2.8%) pregnancy. Interruption of this method occurred in 4 (11.4%) cases due to hypertension (2), pregnancy (1) and amenorrhea (1). In group GIT there were 2 (7.4%) cases of arterial hypertension, 18 (66.6%) of amenorrhea, and 3 (11.1%) of spotting. Interruption of use occurred in 5 (18.5%) due to amnorrhea (2), weight gain (2) and headache (1). In GUID there was 1 (3.7%) case of infeccion, 1 (3.7%) pregnancy and 1 (3.7%) spontaneous expulsion of IUD. Interruption of use took place in 3 (11.1%) cases due to infeccion, pregnancy and expulsion. The comparation between the groups demonstrated a difference in the incidence of amenorrhea (p < 0.005) and descontinuation of use of the method (p < 0.025).


CONCLUSIONS
Use of reversible contraceptives in heart disease women was associated with an acceptable cardiovascular risk. Efficacy and side effects of the methods were comparable in the groups, however intolerance was more observed in GIT.
Avila
W S
WS
Instituto do Coração do Hospital das Clínicas-FMUSP, São Paulo, SP.
Grinberg
M
M
Melo
N R
NR
Aristodemo Pinotti
J
J
Pileggi
F
F
D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D016009:Chi-Square Distribution; D003278:Contraceptives, Oral, Hormonal / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases; D006801:Humans; D007434:Intrauterine Devices / Q000009:adverse effects*; D011247:Pregnancy; D011446:Prospective Studies; D016896:Treatment Outcome
D003278:Contraceptives, Oral, Hormonal