I consider eventual risk of DVT and PE. If one prescribes stopping contraceptive medication, how long is the interval to the planned surgery? Some authors do not recommend it at all in relatively minor and MIS surgeries.
Dear Panayot
The contraceptive use increases the risk of pulmonary embolism. At the hospital where I work, the use of the contraceptive is stopped 1 month before surgery (protocol of clinical medicine and anesthesiology). In this period it is advisable to use another method of contraception to avoid performing surgery in the presence of a pregnancy. It is not an absolute contraindication to perform surgery on duration of oral contraceptive use, but the patient should be aware of all the risks
Thank you, Nelson, for your proper answer. Our preoperative protocol is almost the same. Anyway, it is difficult to control whether our advice is executed correctly by the patients. As far as minor interventions (one-day hospital stay) are concerned, in my opinion stopping the contraceptive could be discussed on but in fact it is out of control.
I would add that in the past (some 35 years ago) we lost a young patient with a meniscectomy from a fatal PE. Unfortunately, at that time the contraception was not discussed as a risk factor for thromboembolic complications. It was really bad.
Dear Panayot
If there is risk factor should be minimized to avoid very serious complications .
Dear Nelson, I agree entirely. It is an important issue which sometimes, in my opinion, is neglected. Regards.
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