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Contraceptive Management of Women with Cardiac Disease

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Contraception for the Medically Challenging Patient

Abstract

Cardiac disease, both congenital and acquired, is increasing in reproductive-aged women, resulting in rising rates of maternal, perinatal, and neonatal morbidity and mortality. Contraceptive care for women with cardiac conditions is complicated by increased risks of thrombogenic alterations, the potential for fluid retention, blood pressure changes, pro-arrhythmic tendency, potential changes in glucose metabolism and lipid profiles, bleeding on warfarin, bacteremia/endocarditis risk, and vasovagal reactions. Contraceptive risks must be weighed against both pregnancy risk and contraceptive efficacy. Fortunately, clinicians who counsel women with cardiac disease have two excellent resources for guidance: the Centers for Disease Control and Prevention’s US Medical Eligibility Criteria and publications from a multidisciplinary working group of experts on the contraceptive management of women with cardiac disease. Due to the increased risks associated with pregnancy for women with many cardiac conditions and the general safety of long-acting reversible contraception for most of these conditions, providers should consider these methods as a first line for women with cardiac disease.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL, USA

    Autumn Davidson M.D. & Julie Chor M.D., M.P.H.

  2. Division of Cardiology, Department of Medicine, University of Illinois Medical Center, Chicago, IL, USA

    Joan Briller M.D.

Authors
  1. Autumn Davidson M.D.
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  2. Joan Briller M.D.
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  3. Julie Chor M.D., M.P.H.
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Correspondence to Julie Chor M.D., M.P.H. .

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Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

    Rebecca H. Allen

  2. Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA

    Carrie A. Cwiak

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Davidson, A., Briller, J., Chor, J. (2014). Contraceptive Management of Women with Cardiac Disease. In: Allen, R., Cwiak, C. (eds) Contraception for the Medically Challenging Patient. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1233-9_2

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