RESUMO
Our aim was to better define the coagulation abnormalities in patients with systemic lupus erythematosus who had thrombosis or high-risk clinical settings for thrombosis. Clinical and laboratory data of 111 patients with lupus referred for coagulation assessment because of thrombosis, pregnancy loss or high-risk clinical settings for thrombosis were reviewed retrospectively. Increased activity of procoagulant factors and decreased activity of anti-coagulant factors were observed well above the expected 5% prevalence. All comparisons were significant at the P < 0.001 level. Anticardiolipin antibodies were present in 70.5% of patients tested (55/78) in this high-risk group, but usually in low titres. Platelet hyperfunction was detected in the majority of patients tested (85.7%, 78/91). Hypercoagulability in lupus is complex and is better defined by assessing multiple haemostatic factors in addition to platelet function. Platelet hyperfunction contributes significantly to thrombophilia in lupus and this is the key finding of our study.
Assuntos
Transtornos Plaquetários/epidemiologia , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/epidemiologia , Trombofilia/epidemiologia , Adulto , Síndrome Antifosfolipídica/epidemiologia , Transtornos Plaquetários/complicações , Estudos de Coortes , Fator V/genética , Feminino , Predisposição Genética para Doença/epidemiologia , Predisposição Genética para Doença/genética , Humanos , Lúpus Eritematoso Sistêmico/complicações , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Michigan/epidemiologia , Pessoa de Meia-Idade , Prevalência , Protrombina/genética , Estudos Retrospectivos , Trombofilia/complicaçõesRESUMO
The purpose of this study was to examine the influence of sociodemographic factors, attitudes, knowledge, and experiences regarding the use of various contraceptive methods, future plans prenatally, and actual use postpartum among a population of low income pregnant women. Women were interviewed prenatally and during the postpartum period in a large, urban academic health center serving primarily an indigent population. The primary analytic method employed was logistic regression. The key finding in this study is that women are not consistently using the method of contraception postpartum that they planned during the prenatal period. Only 54.7% of the women planning to use oral contraceptive pills were using them postpartum, and only 31.3% of the women planning to use condoms were actually using them postpartum. Expanding contraceptive education and counseling throughout the perinatal period may assist women's decision making.
