Mom's Day Monday: Deep Vein Blood Clots From Surgery, Perhaps You Need to Stop Your Contraceptive Pill

We know that women have about a 1/10,000 risk of having a blood clot known as VTE (venous thromboemoblism). When a woman takes birth control pills there is a 3-4 times greater risk of having a VTE, and this is primarily related to the estrogen in the birth control pill. Of course becoming pregnant raises one's risk of a blood clot even more, to as high as 6 or even 10/10,000. Thus the American Congress of Obstetricians and Gynecologists recommends having a discussion with your gyno to decide what your risks and benefits are and whether you should stop your pills before and after surgery for a time, as becoming pregnant is a risk for blood clotting. For women who have surgery planned, there are many factors that may increase her risk of a blood clot or other complication of the surgery. Blood flow is the primary factor: the quicker you are up and active, and the more activity you have, the less likely you are going to have a blood clot. This is in some way related to blood pressure as well. Blood pressure  A new study questions whether planned elective surgery of any sort, not just gynecologic surgery, could be safer at certain times during the menstrual cycle. A researcher who follows menstrual cycle variances has found another conundrum for her data base and sent me a link to look over. In a small study in Turkey it was found that at certain times of the menstrual cycle blood pressure responses to intubation (tube placement in general anesthesia) varied dramatically depending upon the phase of the menstrual cycle. They felt that the blood pressure responses were smoother during the early menstrual phase, and it is true during the very earliest time the levels are lower. The authors are quick to point out that they didn't actually measure the hormone levels of the study subjects nor did they measure the levels of the adrenaline and adrenaline-like substances (catacholamines) that would affect these things. It is very likely that healthy women with very normal blood pressures will not have a medically relevant change in their blood pressure, it is however a concern that someone with abnormal blood pressures or other medically unstable factors could have this be an issue. It is important to keep reading about this issue and when scheduling surgeries there are a lot of factors to consider.


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