Investigation of the Possible Effects of Injectable and Skin Patch Contraceptives on Selected Haemostatic and Haematologic Parameters in Women Attending Primary Healthcare Centre in Eleme, Rivers State
Journal of Pharmaceutical Research International,
The was a case control and comparative study aimed at investigating the possible effects of injectable and skin patch contraceptives on selected haematologic and haemostatic parameters in women attending primary healthcare centre at Eleme, Rivers State The study population consists of seventy-five (75) apparently healthy, non-pregnant, non- smoking women, aged between 25 and 45years; (31 women on DEPO-PROVERA contraceptive, 14 women on Implanon, and 30 apparently healthy non-contraceptive users as control group). Fibrinogen, antithrombin, tissue plasminogen activator was analysed with reagents prepared by Elabscience, Wuhan, China, using an ELISA machine (STAT FAX-2100). Prothrombin time and activated partial thromboplastin time was done manually with reagents prepared by Quimica Clinica Aplicada S.A, Spain. Haematologic parameters were analysed using SYSMEX KX-21-N auto analyser. Graph-pad Prism 5.0 was used in analysing all data, p < 0.05 was considered statistically significant. For haemostatic parameters, results showed that there was statistically significant increase in mean values of antithrombin (38.48 ± 17.48/ml versus 21.02 ± 15.54ng/ml, p=0.0011) and tissue plasminogen activator (1.34 ± 1.35ng/ml versus 0.28 ± 0.46ng/ml, p=0.0047) in women using the two types of contraceptive, while activated partial thromboplastin time (28.11± 2.37s versus 29.87 ± 2.77s, p=0.0205) was statistically decreased in women on the investigated contraceptives, other haemostatic parameters were not statistically significant. For haematological parameters, the results showed that there was statistically significant increase in mean values of packed cell volume 38.13 ± 2.28% versus 36.21 ± 3.07% (p=0.0126), haemoglobin 12.35 ± 0.79g/dL versus 11.56 ± 0.99g/dL (p=0.0028), white blood cells 6.17 ± 1.22 x109/L versus 5.26 ± 1.18 x109/L (p=0.0143) in women using injectable (DEPO-PROVERA) and skin patch (IMPLANON) contraceptive, other parameters showed no statistically significance. Based on duration of use of contraceptive, there was no statistically significant difference (p>0.05) in women using skin patch; while for injectable, platelet count was high in those who had used it for more than a year. Comparing values obtained from using injectable and skin patch, there was no statistical significant difference in all the parameters. Using analysis of variance to compare values based on parity, there was no statistical significant difference. Conclusively, increase in antithrombin and tissue plasminogen activator, and a decrease in activated partial thromboplastin time in women using IMPLANON (skin patch) and DEPO-PROVERA (injectable) are the haemostatic changes that occurs while using contraceptives and these changes may likely predispose them to bleeding, therefore adequate monitoring of the blood haemostatic processes while taking these contraceptives is critical in order not to expose users to haemorrhage.
- injectable contraceptive
- skin patch contraceptive
How to Cite
Mosher WD, Jones J. Use of Contraception in the United States: 1982 -2008. Vital Health Stat. 2010;(29):1-44.
Blackstone SR, Iwelunmor J. Determinants of contraceptive use among Nigerian couples: evidence from the 2013 Demographic and Health Survey. Contracept Reprod Med. 2017;2:9. Available:https://doi.org/10.1186/s40834-017-0037-6
Jacobstein R, Polis CB. Progestin-only contraception: Injectables and Implants. Best Pract Res Clin Obstet Gynaecol. 2014;28(6):795-806. DOI: 10.1016/j.bpobgyn.2014.05.003
Lidegaard O, Løkkegaard E, Svendsen AL, Agger C. Hormonal contraception and risk of venous thromboembolism: National follow-upstudy. BMJ. 2009;339:b2890. DOI: 10.1136/bmj.b2890
Phzer. DEPO-PROVERA® Contraceptive Injection medroxyprogesterone acetate injectable suspension, USP; 2006.
Croxatto HB. Mechanisms that explain the contraceptive action of progestin implants for women. Contraception. 2002;65(1):21-7.
Organon. IMPLANON™ (etonogestrel implant) 68 mg for subdermal use only; 2008. Available:www.accessdata.fda.gov Accessed 31st January 2018.
Audet MC, Moreau M, Koltun WD, Waldbaum AS, Shangold G, Fisher AC, Creasy GW. ORTHO, EVRA/EVRA 004 Study Group: Evaluation of contraceptive efficacy and cycle control of a transdermal contraceptive patch vs. An oral contraceptive. JAMA. 2001;285(18):2347-54.
Janssen-Cilag International NV. Evra transdermal patch. Summary of product characteristics; 2014. Available:http://www.janssen-cilag.co.uk/product/pdf/spc/ Accessed 18th July, 2014.
Afsar NA, Barakzai Q, Adil SN. Effect of a Progestin only` contraceptive on platelet aggregation in a Pakistani set of population. J Ayub Med Coll Abbottabad. Journal of Ayub Medical College Abottabad. 2005;17(3):21-5.
Braverman PK, Adelman WP, Alderman EM, Breuner CC, Levine DA, Marcell AV, O'Brien RF. Contraception for adolescents. Pediatrics. 2014;134(4): e1244-56. DOI: 10.1542/peds.2014-2299
Mohamed JMA, Wahda BA. Evaluation of the effect of Depot Medroxyprogesterone Acetate injection as contraceptive on some coagulation parameters. Journal of Pharmacy Research. 2014;8(8):1022-1026.
Whigham KA, Howie PW, Mack A, Prentice CR. The effect of an injectable progestogen contraceptive on blood coagulation and fibrinolysis. Br J Obstet Gynaecol. 1979;86(10):806-9.
Joseph JT, Abdulazeez AA, Obisesan OA. Effect of hormonal contraceptives on some haemostatics parameters in women attending family planning clinics in Jos, Nigeria. Nigerian Journal of Health and Biomedical Science. 2008;7(1):15-8.
Egbunah MO, Eze EM, Ebirien-Agana BS, Jeremiah ZA. Haematological profiles of women on some contraceptives in selected family planning clinics in Kaduna State, Nigeria. Journal of Medical Science and Clinical Research. 2018;6(12):73-84. Available:https://dx.doi.org/10.18535/jmscr/v6i12.12
World Health Organisation. Effects of contraceptives on hemoglobin and ferritin. Task Force for Epidemiological Research on Reproductive Health, United Nations Development Programme/United Nations Population Fund/World Health Organization/ World Bank Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland. Contraception. 1998; 58(5):262-73.
Stanford SN, Sabra A, D’Silva L, Lawrence M, Morris RHK, Storton S, Brown MR, Evans V, Hawkins K, Williams PR, Davidson SJ, Wani M, Potter JF, Evans PA. The changes in clot microstructure in patients in patients with Ischaemic stroke and the effect of therapeutic intervention: A prospective observational study. BMC Neurology. 2015; 15:35. DOI: 10.1186/s12883-015-0289-1
Di Napoli M, Papa F. (2011). Should neurologists measure fibrinogen concentration? J Neurol Sci. 2006;246:5–9.
Abstract View: 300 times
PDF Download: 173 times