Применение комбинированных оральных контрацептивов, даже низко- и микродозированных, должно основываться на индивидуальной оценке степени риска развития тромботических осложнений. Целесообразно сочетать комбинированные оральные контрацептивы с поливитаминными комплексами, оказывающими влияние на систему гемостаза, в первую очередь сосудисто-эндотелиальный компонент (Дуовит® для женщин). Лечебное применение комбинированных оральных контрацептивов у женщин группы высокого риска по реализации тромбозов возможно одновременно с противотромботическими средствами (препаратами гепаринового ряда). Ключевые слова: гормональная контрацепция, факторы риска, венозные тромбоэмболические осложнения, поливитаминные комплексы.
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The use of COCs, even low- and microdosed should be based on an individual assessment of the risk of thrombotic complications. It is advisable to combine the COC together with multivitamin complexes that affect the hemostatic system in the first place, vascular endothelial component (Duovit® for women). The therapeutic use of COCs in women high risk of VTE may together with antithrombotic drugs (heparin and LMWH). Key words: hormonal contraception, risk factors, venous thromboembolism, multivitamin complexes.
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5. Lidegaard O, Nielsen LH, Skovlund CW, Lokkegaard E. Venous thrombosis in users of non-oral hormonal contraception: follow-upstudy, Denmark 2001–2010. BMJ 2012; 344: 2990–8.
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9. Folkeringa N, Brouwer JLP, Korteweg F et al. High risk of pregnancy-related venous thromboembolism in women with multiple thrombophilic defects. Br J Haematol 2007; 138 (1): 110–6.
10. Ray JG, Chan WS. Deep vein thrombosis during pregnancy and the puerperium: a meta-analysis of the period of risk and the leg of presentation. Obstet Gynecol Surv 1999; 54 (4): 265–71.
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14. Hugon-Rodin J, Gompel A, Plu-Bureau G. Epidemiology of hormonal contraceptives-related venous thromboembolism. Eur J Endocrinol 2014; 171 (6): R221–30.
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16. Perrot-Applanat M, Cohen-Solal K, Milgrom E, Finet M. Progesterone receptor expression in human saphenous veins. Circulation 1995; 92 (10): 2975–83.
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18. Sidney S, Petitti DB, Soff GA et al. Venous thromboembolic disease in users of low-estrogen combined estrogen-progestin oral contraceptives. Contraception 2004; 70: 3–10.
19. Stegeman BH, de Bastos M, Rosendaal FR et al. Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis. BMJ 2013; 347: f5298.
20. De Bastos M, Stegeman BH, Rosendaal FR et al. Combined oral contraceptives: venous thrombosis. Cochrane Database of Systematic Reviews 2014; 3: CD010813.
21. Plu-Bureau G, Maitrot-Mantelet L, Hugon-Rodin J, Canonico M. Hormonal contraceptives and venous thromboembolism: an epidemiological update. Best Practice & Research. Clin Endocrinol Metab 2013; 27 (1): 25–34.
22. Martinez F, Ramirez I, Perez-Campos E et al. Venous and pulmonary thromboembolism and combined hormonal contraceptives. Systematic review and meta-analysis. Eur J Contracept Reprod Health Care 2012; 17 (1): 7–29.
23. Wu CQ, Grandi SM, Filion KB et al. Drospirenone-containing oral contraceptive pills and the risk of venous and arterial thrombosis: a systematic review. BJOG: an Int J Obstet Gynaecol 2013; 120 (7): 801–10.
24. Ших Е.В. Взаимодействие компонентов витаминно-минеральных комплексов и рациональная витаминотерапия. Consilium Mеdicum. 2004; 6 (12). / Shikh E.V. Vzaimodeistvie komponentov vitaminno-mineral'nykh kompleksov i ratsional'naia vitaminoterapiia. Consilium Medicum. 2004; 6 (12). [in Russian]
25. Zal F, Mostafavi-Pour Z, Amini F, Heidari A. Effect of vitamin E and C supplements on lipid peroxidation and GSH-dependent antioxidant enzyme status in the blood of women consuming oral contraceptives. Contraception 2012; 86 (1): 62–6.
26. Кирющенков П.А., Шмаков Р.Г., Андамова Е.В., Тамбовцева М.А. Алгоритм клинико-гемостазиологического обследования в акушерско-гинекологической практике. Акуш. и гинекол. 2013; 1: 101–6. / Kiriushchenkov P.A., Shmakov R.G., Andamova E.V., Tambovtseva M.A. Algoritm kliniko-gemostaziologicheskogo obsledovaniia v akushersko-ginekologicheskoi praktike. Akush. i ginekol. 2013; 1: 101–6. [in Russian]
________________________________________________
1. Kubba A, Guillebaud J, Anderson RA, MacGregor EA. Contraception. Lancet 2000; 356 (9245): 1913–9.
2. Petitti DB. Clinical practice. Combination estrogen-progestin oral contraceptives. N Engl J Med 2003; 349 (15): 1443–50.
3. Rukovodstvo po kontratseptsii. Pod red. V.N.Prilepskoi. M.: MEDpress-inform, 2006. [in Russian]
4. Carpenter SEK, Rock JA. Paediatric and Adolescent Gynecology. Philadelphia: Lippincott WW, 2000.
5. Lidegaard O, Nielsen LH, Skovlund CW, Lokkegaard E. Venous thrombosis in users of non-oral hormonal contraception: follow-upstudy, Denmark 2001–2010. BMJ 2012; 344: 2990–8.
6. Reid R, Leyland N, Wolfman W et al. SOGC clinical practice guidelines: Oral contraceptives and the risk of venous thromboembolism: an update: no. 252, December 2010. Int J Gynaecol Obstet 2011; 112 (3): 252–6.
7. Momot A.P., Taranenko I.A., Tsyvkina L.P. Evoliutsiia predstavlenii o trombofilii i ee roli v problemakh reproduktsii cheloveka. Akush. i ginekol. 2013; 2: 4–9. [in Russian]
8. James AH, Tapson VF, Goldhaber SZ. Thrombosis during pregnancy and the postpartum period. Am J Obstet Gynecol 2005; 193 (1): 216–9.
9. Folkeringa N, Brouwer JLP, Korteweg F et al. High risk of pregnancy-related venous thromboembolism in women with multiple thrombophilic defects. Br J Haematol 2007; 138 (1): 110–6.
10. Ray JG, Chan WS. Deep vein thrombosis during pregnancy and the puerperium: a meta-analysis of the period of risk and the leg of presentation. Obstet Gynecol Surv 1999; 54 (4): 265–71.
11. Sanson BJ, Simioni P, Tormene D et al. The incidence of venous thromboembolism in asymptomatic carriers of a deficiency of antithrombin, protein C, or protein S: a prospective cohort study. Blood 1999; 94 (11): 3702–6.
12. Zainulina M.S., Korniushina E.A., Bikmullina D.R. Trombofiliia: etiologicheskii faktor ili patogeneticheskii aspekt oslozhnennogo techeniia beremennosti? Zhurn. akusherstva i zhenskikh boleznei. 2010; LIX (1): 18–30. [in Russian]
13. Sammaritano LR. Contraception in patients with systemic lupus erythematosus and antiphospholipid syndrome. Lupus 2014; 23 (12): 1242–5.
14. Hugon-Rodin J, Gompel A, Plu-Bureau G. Epidemiology of hormonal contraceptives-related venous thromboembolism. Eur J Endocrinol 2014; 171 (6): R221–30.
15. Tchaikovski SN, Rosing J. Mechanisms of estrogen-induced venous thromboembolism. Thromb Res 2010; 126 (1): 5–11.
16. Perrot-Applanat M, Cohen-Solal K, Milgrom E, Finet M. Progesterone receptor expression in human saphenous veins. Circulation 1995; 92 (10): 2975–83.
17. Veljković M, Popovć J. Venous thromboembolism and oral contraception. Med Pregl 2010; 63 (5–6): 376–9.
18. Sidney S, Petitti DB, Soff GA et al. Venous thromboembolic disease in users of low-estrogen combined estrogen-progestin oral contraceptives. Contraception 2004; 70: 3–10.
19. Stegeman BH, de Bastos M, Rosendaal FR et al. Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis. BMJ 2013; 347: f5298.
20. De Bastos M, Stegeman BH, Rosendaal FR et al. Combined oral contraceptives: venous thrombosis. Cochrane Database of Systematic Reviews 2014; 3: CD010813.
21. Plu-Bureau G, Maitrot-Mantelet L, Hugon-Rodin J, Canonico M. Hormonal contraceptives and venous thromboembolism: an epidemiological update. Best Practice & Research. Clin Endocrinol Metab 2013; 27 (1): 25–34.
22. Martinez F, Ramirez I, Perez-Campos E et al. Venous and pulmonary thromboembolism and combined hormonal contraceptives. Systematic review and meta-analysis. Eur J Contracept Reprod Health Care 2012; 17 (1): 7–29.
23. Wu CQ, Grandi SM, Filion KB et al. Drospirenone-containing oral contraceptive pills and the risk of venous and arterial thrombosis: a systematic review. BJOG: an Int J Obstet Gynaecol 2013; 120 (7): 801–10.
24. Shikh E.V. Vzaimodeistvie komponentov vitaminno-mineral'nykh kompleksov i ratsional'naia vitaminoterapiia. Consilium Medicum. 2004; 6 (12). [in Russian]
25. Zal F, Mostafavi-Pour Z, Amini F, Heidari A. Effect of vitamin E and C supplements on lipid peroxidation and GSH-dependent antioxidant enzyme status in the blood of women consuming oral contraceptives. Contraception 2012; 86 (1): 62–6.
26. Kiriushchenkov P.A., Shmakov R.G., Andamova E.V., Tambovtseva M.A. Algoritm kliniko-gemostaziologicheskogo obsledovaniia v akushersko-ginekologicheskoi praktike. Akush. i ginekol. 2013; 1: 101–6. [in Russian]
Авторы
П.А.Кирющенков*, М.А.Тамбовцева
ФГБУ Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова Минздрава России. 117997, Россия, Москва, ул. Академика Опарина, д. 4
*masha-kirmail@mail.ru
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P.A.Kiryushchenkov*, M.A.Tambovtseva
Research Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of the Russian Federation.
117997, Russian Federation, Moscow, ul. Akademika Oparina, d. 4
*masha-kirmail@mail.ru