Venous thrombosis in women : pregnancy, the contraceptive pill, and hormone replacement therapy : I.A. Greer

The impact of hormones on deep venous thrombosis is one of the most charged and debated subjects in contraceptive medicine. Female hormonal balance is primarily affected by the use of either oral contraceptives or HRT. For a long time it has been recognized that oral contraceptives can raise the incidence of DVT; however, there has been an enormous controversy as to whether all progestins do this equally or whether some have a greater impact than others where oral contraception is concerned. Written by a world leader on the subject, this book offers the latest clinical information about the effects of pregnancy, the contraceptive pill, and hormone replacement therapy on thrombotic problems in women. Book Cover......Page 1 Half-Title......Page 2 Title......Page 3 Copyright......Page 4 Contents......Page 5 I Overview of the hemostatic and fibrinolytic systems......Page 7 2.1 PLATELETS IN PREGNANCY......Page 15 2.2 COAGULATION FACTORS......Page 16 2.3 ENDOGENOUS ANTICOAGULANTS AND PREGNANCY......Page 17 2.4 FIBRINOLYSIS......Page 18 2.5 SUMMARY: HEMOSTASIS IN NORMAL PREGNANCY......Page 20 3 Venous thromboembolism in pregnancy......Page 21 3.1 THE PROBLEM OF VENOUS THROMBOEMBOLISM INPREGNANCY......Page 22 3.2 RISK FACTORS FOR VTE IN PREGNANCY......Page 24 3.3 LONG-TERM MORBIDITY FROM PREGNANCY-ASSOCIATED VTE......Page 26 3.4 PATHOPHYSIOLOGY OF PREGNANCY-ASSOCIATED VTE......Page 27 3.5 THROMBOPHILIA AND PREGNANCY-ASSOCIATEDVENOUS THROMBOSIS......Page 29 3.6 THROMBOPHILIA AND ADVERSE PREGNANCYOUTCOME......Page 34 3.7 SCREENING FOR CONGENITAL THROMBOPHILIA INPREGNANCY......Page 41 3.8 DIAGNOSIS OF VTE IN PREGNANCY......Page 44 Coumarins......Page 47 Heparins......Page 48 3.10 MANAGEMENT OF ACUTE GESTATIONAL VTE......Page 50 3.11 LABOR AND CESAREAN SECTION IN THE WOMANWITH VTE IN PREGNANCY......Page 55 3.12 THROMBOPROPHYLAXIS IN PREGNANCY......Page 57 4.1 EPIDEMIOLOGY OF VENOUS THROMBOEMBOLISMAND THE ORAL CONTRACEPTIVE PILL......Page 65 4.2 HERITABLE THROMBOPHILIA AND THE ORALCONTRACEPTIVE PILL......Page 71 4.3 HEMOSTATIC EFFECTS OF THE COMBINED ORALCONTRACEPTIVE PILL......Page 72 4.4 IMPLICATIONS FOR PRACTICE......Page 73 5.1 EPIDEMIOLOGY OF VENOUS THROMBOEMBOLISMAND HORMONE REPLACEMENT THERAPY......Page 77 Effects of HRT on hemostasis and thrombosis......Page 84 5.3 THROMBOPHILIA, HRT AND RISK OF VTE......Page 86 5.4 RISK FACTORS FOR VTE AND HRT......Page 88 Risk factor assessment and thrombophilia screening......Page 89 References......Page 93 Index......Page 114