Contraception for women with heart disease: an update.

BACKGROUND

It is estimated that by the year 2013, 303.000 women worldwide died as a result of pregnancy-related conditions. The risk of pregnancy complications in women with heart disease depends on the specific disease and on the individual conditions of each patient.

EVIDENCE ACQUISITION

A bibliographic research was carried out on PubMed using the descriptors "heart disease" AND "contraceptive" OR "pregnancy" AND "thrombosis" OR "angina" OR "cardiopathy". A total of 1456 articles were found.

EVIDENCE SYNTHESIS

Classification of heart disease in pregnancy according to the severity of the condition include high, intermediate or low-risk cardiac patients. Tubal ligation is indicated for women with high-risk heart disease. Reversible methods are possible for intermediate or low-risk cardiac patient, but formal contraindications for estrogens are present in large percentage of clinical conditions and progestogen-only formulations are generally considered. Contraindications to the use of an intrauterine device disease should be considered.

CONCLUSIONS

According to the different forms of heart disease, different contraceptive methods are recommended.