Contraception and cardiovascular disease.
Contraceptive counselling should begin early in females with heart disease, preferably directly after the start of menstruation. In coming to a decision about the method of contraception, the following issues should be considered: (i) the risk of pregnancy for the mother and the consequences of an unplanned pregnancy; (ii) the risks of the contraceptive method; (iii) failure rates; (iv) the non-contraceptive benefits; (v) the availability; (vi) the individual's preferences; (vii) protection against infection; and (viii) costs. In some women with heart disease, the issues may be complex and require the input of both a cardiologist and an obstetrician (or other feto-maternal expert) to identify the optimal approach. No studies have been performed in women with heart disease to investigate the relative risks and benefits of different contraceptive methods.
Department of Cardiology, Erasmus Medical Center, Office Ba 308, Postbus 2040, Rotterdam 3000 CA, The Netherlands j.roos@erasmusmc.nl.
Jolien W
JW
Roos-Hesselink
Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, The Netherlands.
Jerome
J
Cornette
Department of Cardiology, Hatter Institute for Cardiovascular Research in Africa, MRC Cape Heart Group & IDM, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Karen
K
Sliwa
Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Petronella G
PG
Pieper
Department of Cardiology, Heart Institute Cincinnati Children's Hospital Medical Centre, 3333 Burnet Avenue, Cincinnati 45229, USA.
Gruschen R
GR
Veldtman
Academic Department of Obstetrics and Gynaecology, Imperial College School of Medicine, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK.
Mark R
MR
Johnson
D000925:Anticoagulants; D003075:Coitus; D003267:Contraception / Q000009:adverse effects / Q000379:methods*; D044363:Contraception, Postcoital; D003271:Contraceptive Agents, Female; D000075202:Contraindications; D003376:Counseling; D004967:Estrogens; D005260:Female; D006331:Heart Diseases / Q000517:prevention & control*; D006801:Humans; D007434:Intrauterine Devices; D010353:Patient Education as Topic; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000517:prevention & control*; D049168:Pregnancy, Unplanned; D011374:Progesterone; D013245:Sterilization, Reproductive
D000925:Anticoagulants; D003271:Contraceptive Agents, Female; D004967:Estrogens; D011374:Progesterone
Cardiovascular; Contraception; Heart disease; Pregnancy