Abstract

PIP: In acute thrombosis of deep veins of the lower extremities, post-thrombotic syndrome develops in 75% of cases and leads to premature debilitation in 1/3 of the patients. Besides known thrombogenic causes, hormonal preparations more and more often are factors in occurrence of acute thrombosis. There is no doubt that hormonal contraceptive agents are the most reliable method of preventing pregnancy. Their widespread use has resulted in a significant decrease in septic abortions with serious consequences. The purpose of this article is not to discredit this method of preventing pregnancy, but merely to ascertain the presence or lack of a link between thromboembolic diseases and the use of hormonal contraceptive agents. Disturbance of the balance between clotting and anti-clotting systems contributes to development of thrombosis. Etiological factors include changes in vascular walls and functional impairment of hemodynamics. A decrease in the level of antithrombin III in the blood and also in the amount of heparinocytes after using hormonal contraceptive agents has also been proven. Postoperative and postnatal hypodynamics, thrombophlebitis with chronic venous insufficiency, neoplastic syndrome and trauma are causes of acute thrombosis. Age, obesity, hypertonic disease and smoking serve as other risk factors. From 1975 to 1981, 72 women were in the surgical clinic of the Mardeburg Medical Academy for treatment of acute thromboembolic diseases: 34 were using hormonal contraceptive agents before onset of the disease; 19 smoked up to 10 cigarettes a day; and 5 smoked occasionally. After operative intervention, 20 women developed acute thrombosis; only 2 of them were using hormonal contraceptives. No clear causes of thrombosis were found in 35 women, but 32 of them were using hormonal contraceptives. Trauma was the cause in 1 woman with thrombosis of the cartoid artery. On the average, the women used hormonal contraceptives for 4.1 years before onset of the disease (3.1 years in thrombosis of veins of the lower extremities and pelvis; 5.1 in arterial thrombosis). In 28 of 34 women with acute thromboses, they were localized in the veins of the lower extremities and pelvis after taking hormonal contraceptives. Women with thromboembolic diseases after taking hormonal contraceptives had general examinations at periods from 6 months to 5 years. Development of post-thrombotic syndrome was observed in 12 women with thrombosis of veins in the lower extremities and pelvis. Thromboses without any thrombogenic causes were observed in women under 30 after taking hormonal contraceptives. Although a direct link between the use of hormonal contraceptive agents and thromboembolic diseases cannot be proven presently, taking these preparations is believed to be 1 of the risk factors in the development of these diseases.