Abstract:
Objective: To collect data on the use of hormonal contraception in the Czech Republic in 1998.
Setting: Department of Gynaecology and Obstetrics, Charles University School of Medicine and
General University Hospital Prague.
Methods: A total of 2.134 questionnaires were sent to Czech gynaecologists in spring 1999. A total
of 418 answers were processed.
Results: The estimated number of users presenting in gynaecologist’s offices participating in our
project was 237.099 women. The most often prescribed contraceptives were monophasic products
(54.38%) containing 30 - 35 mg of ethinyl-estradiol (55.21%) with new progestins (53.8%) (norgesti-
mate, gestoden, desogestrel). Regular follow-up of hormonal contraceptive users included the
following examinations/tests: blood count in 8.5% offices, ultrasound examination in 8.0% offices,
lipid spectrum in 49.8% offices, blood pressure in 74% offices, colposcopy in 97.6% offices, oncolo-
gical cytology in 98.4% offices and liver tests in 77.1% gynecologist’s offices. Only 10.85% of the
gynaecologists did not perform lipid tests, almost 20% gynaecologists measured blood pressure
only selectively in some users. 80 cases of cardiovascular disease were diagnosed, a figure consis-
tent with an 0.0325% incidence of users. The most frequent complication was deep venous throm-
bosis (58 cases). The subgroup of women experiencing a cardiovascular event was not
characterized by older age, higher body weight, more frequent smoking, or use of products with
a higher oestrogen contents.
Conclusion: There were major differences among gynaecologists in the follow-up of hormonal
contraception users. The pattern of the products used varied markedly by regions. The number of
diagnosed cardiovascular diseases was very low. Users with a previous a cardiovascular event
were only exceptionally carriers of a risk factor.
Key words:
hormonal contraception, cardiovascular disease, deep vein thrombosis, liver tests, lipids
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