[Contraception, therapeutic abortion, and pulmonary arterial hypertension].
Despite therapeutic advances, maternal mortality is high in pulmonary arterial hypertension (PAH). PAH treatment may interfere with the proposed method of contraception. Moreover, some treatments (endothelin receptor antagonists, anti-vitamin K) are teratogenic. If pregnancy is strictly not recommended in PAH, few specific contraceptive guidelines are available. The contraceptive method must be discussed on a case by case basis with the patient, the reference team for PAH, and the gynecology department.The advantages of the intrauterine device (IUD) with progesterone (reliability, simplicity, compliance, few contraindications and interactions, possibility of use in the nulliparous patient, reimbursement by the healthcare system) make it a good contraceptive choice in these circumstances. Therapeutic abortion is a situation of contraceptive failure, it must always be performed in hospitals. It must lead to effective contraceptive advice.
Frachon
Irène
I
Université Européenne de Bretagne, and Université de Brest, Brest, France. irene.frachon@chu-brest.fr
Gaudin
Stéphanie Pozzi
SP
Jezequel
Catherine
C
Jaïs
Xavier
X
Gut-Gobert
Christophe
C
Christophe
Sandrine Roger
SR
Humbert
Marc
M
Leroyer
Christophe
C
D000032:Abortion, Therapeutic / Q000379:methods; D003267:Contraception / Q000379:methods; D005193:Family Planning Services; D005260:Female; D005865:Gestational Age; D006801:Humans; D006976:Hypertension, Pulmonary / Q000401:mortality / Q000517:prevention & control*; D008428:Maternal Mortality; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality / Q000517:prevention & control*; D013245:Sterilization, Reproductive / Q000379:methods