Summary:
Background: Oral contraceptive pill (OCP) is widely used
by millions of women of various socioeconomic
conditions.Use of low dose oestrogen and newer progesterone
in OCP now associated with less thromboembolic and
cardiovascular risk. The safety aspects of these pills had not
been investigated in details in malnourished women of
developing countries. In the present study the effects of the
pillson coagulation status have been studied.
Objective: To explore the effect of the most widely used low
dose OCP (Shukhi) on coagulation status of Bangladeshi
women with normal and low BMI(Body Mass Index).
Materials and Methods: The study population group (n=29)
comprised of women with normal BMI and the underweight
group (n=11,BMI<18.5). Both groups use low dose OCP(30μg
ethinyl estradiol and 150μg levonorgestrel) for 6-60 months.
The coagulation status were assessed as follows: Plasma
Fibrinogen, Prothrombin time and Platlete aggregation and
Anticoagulation statuseg: AntithrombinIII (ATIII).
Result:Coagulation status showed no significant difference
in platelet aggregation between the groups. Plasma fibrinogen
median value (450mg/dl) just exceeded the upper limit of
reference range (normal range: 200-400mg/dl) in normal BMI.
In contrast, the corresponding value in the low BMI (318mg/
dl) group was almost at the middle of the reference range. A
significantly prolonged prothrombin time (13.80 seconds) was
found in the low BMI group (p=0.058); values were still
within the reference range (10-14 seconds). No significant
correlation existed between plasma fibrinogen, prothrombin
time and platelet aggregation in normal BMI or low BMI
groups. Antithrombin IIIactivity in normal BMI group was
108% and in low BMI group it was 105%. Atendency of
positive correlation existed between antithrombin III activity
and BMI in low BMI pill users (r=0.591,p=0.072).
Conclusion:The study suggested that a) Reported risk of
procoagulant or thromboembolic changes in pill users is
lower in low BMI &normal BMI and b) Low BMI users
showed significantly longer prothrombin time due to the
effect of malnutrition itself or due to the effect of pills in this
nutritional background.
Keywords: Low dose OCP, Coagulation status, Normal and
low BMI women.
(J Bangladesh Coll Phys Surg 2017; 35: 3-8)