Thrombophilic conditions in the adolescent: the gynecologic impact.
As Virchow's triad suggests, a fine balance exists between the vascular wall, intravascular contents, and dynamic blood flow, such that a shift in this balance predisposes to thrombosis. Although thromboembolic events (TEs) are relatively infrequent in adolescents, the morbidity and mortality associated with TEs can be significant. Over the past 15 years, TEs and inherited and acquired thrombophilic conditions underlying them have become increasingly recognized in teens at risk, with combined hormonal contraception constituting one of the most significant of these risk factors. Therefore, managing gynecologic problems in teens who have thrombophilic conditions can be challenging. It is important to have a clear understanding about safe options available to help address adolescent gynecologic concerns in this setting and to manage situations collaboratively with a hematologist.
Dietrich
Jennifer E
JE
Department of Obstetrics and Gynecology, Baylor College of Medicine, 6620 Main Street, Suite 1450, Houston, TX 77030, USA. jedietri@bcm.edu
Yee
Donald L
DL
D000293:Adolescent; D001777:Blood Coagulation; D003271:Contraceptive Agents, Female / Q000009:adverse effects; D003937:Diagnosis, Differential; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D012739:Gonadal Steroid Hormones / Q000009:adverse effects; D006801:Humans; D019851:Thrombophilia / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D013927:Thrombosis / Q000209:etiology* / Q000517:prevention & control
D003271:Contraceptive Agents, Female; D005343:Fibrinolytic Agents; D012739:Gonadal Steroid Hormones