Life-Threatening Complications of Hormonal Contraceptives: A Case History

Saheed Khan,Yvo M Smulders,Johanna I P De Vries,Angélique M E Spoelstra-De Man

doi:10.1155/2013/186230

Saheed Khan, Yvo M Smulders + Show 2 more

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https://doi.org/10.1155/2013/186230

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Abstract

We present a case with the rare combination of thrombotic and hemorrhagic complications of oral contraceptives. A healthy 40-year-old woman suffered from cardiac arrest due to massive pulmonary embolism, caused by oral contraceptives and immobilization during a flight. After successful resuscitation, obstructive shock necessitated thrombolysis and thereafter heparin. Anticoagulation was complicated by internal bleeding from contraceptive related hepatic adenoma. She underwent arterial embolisation, and anticoagulation was continued. On day 18, she was discharged in a good condition. Hepatic adenomas are a potential source of internal bleeding in women using oral contraceptives requiring anticoagulation. Signs of internal bleeding in such patients should prompt immediate abdominal ultrasound examination.

Highlights

Case ReportWe present a case with the rare combination of thrombotic and hemorrhagic complications of oral contraceptives
Oral contraceptives (OAC) are used worldwide and generally considered safe
The dose of the estrogen constituent and the type of progestin determine the risk of venous thromboembolism [1]

Summary

Case Report

We present a case with the rare combination of thrombotic and hemorrhagic complications of oral contraceptives. A healthy 40-year-old woman suffered from cardiac arrest due to massive pulmonary embolism, caused by oral contraceptives and immobilization during a flight. Obstructive shock necessitated thrombolysis and thereafter heparin. Anticoagulation was complicated by internal bleeding from contraceptive related hepatic adenoma. She underwent arterial embolisation, and anticoagulation was continued. Hepatic adenomas are a potential source of internal bleeding in women using oral contraceptives requiring anticoagulation. Signs of internal bleeding in such patients should prompt immediate abdominal ultrasound examination

Introduction

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Discussion

Conclusion