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  • Title: The effects of Norplant on clinical chemistry in Singaporean acceptors after 1 year of use: I. Haemostatic changes.
    Author: Viegas OA, Singh K, Koh S, Singh P, Ratnam SS.
    Journal: Contraception; 1988 Sep; 38(3):313-23. PubMed ID: 3139360.
    Abstract:
    A longitudinal study of coagulation parameters was carried out on 100 Singaporean acceptors using the levonorgestrel subdermal implants NORPLANT for contraceptive purposes. At the end of 1 year of use, results from this on-going study indicate that these subjects may have an increased predisposition to thrombosis as evidenced by significant increase in platelet count and aggregability. The results also show that NORPLANT acceptors may have an enhanced potential for hypercoagulation - with a significant shortening of their Prothrombin Time and Activated Partial Thromboplastin Time and increases in Factors V and X. As previously documented, mean values for haemoglobin and haematocrit were significantly elevated by the end of 1 year. A number of other parameters achieved statistically significant differences by the end of 1 year but these were probably due to the large sample size involved and were therefore not likely to be of much clinical importance. The association between contraceptive agents and the risk of thromboembolism is known. Norplant is a relatively new subdermally implanted contraceptive delivery system, which releases a continuous low dose of the progestagen levonorgestrel over a period of 5 years or more. The present study examines 22 hemostatic parameters in 100 healthy, nonsmoking Singaporean women after 6 months and after 1 year of Norplant use. At the end of 1 year, there was a significant increase in platelet count and platelet aggregation, both of which indicate an increased risk of thrombosis. Prothrombin time and activated partial thromboplastin time were both significantly shortened, and Factor V and Factor X levels were elevated. These results indicate an increased potential for hypercoagulation. Mean values of hematocrit and hemoglobin were elevated. There was a decrease in the level of Factor VII and an increase in antithrombin III antigen level. It is intended that this longitudinal study be continued for the full 5 years, and it is suggested that similar studies be conducted in different populations.
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