Prevalence of cerebral venous thrombosis with the use of oral contraceptive pills during the Holy month of Ramadan

Saudi Med J. 2020 Oct;41(10):1063-1069. doi: 10.15537/smj.2020.10.25397.

Abstract

To identify the epidemiologic profile of cerebral vein thrombosis (CVT) among fasting women using oral contraceptive pills (OCPs) during the holy month of Ramadan. Methods: This retrospective study was conducted on all patients diagnosed with CVT and using OCPs from records at a tertiary care hospital in Riyadh, Saudi Arabia during 2016-2017. The study participants were categorized into 2 groups (an intermittently fasting group during the holy month of Ramadan and a non-fasting group). Results: Out of 108 female patients with CVT, 36.1% were secondary to OCP, of whom 41% participants were fasting. The most affected site was the transverse sinus. Holocephalic headache was more common amongst fasting group (68.8%) compared to non-fasting group (30.4%) (p=0.025). Dehydration (p=0.003) amongst the fasting group and protein S deficiency (p=0.027) in the non-fasting group were identified as the 2 prominent risk factors. Unfractionated heparin was the most common anticoagulant therapies used during the initiation phase for non-fasting (36.4%) and fasting groups (50%). Conclusion: All women who are using OCP should undergo formal written risk assessments for factors of CVT. Our study suggests that the negative effects of OCPs use might outweigh its benefits; thus, it should be prescribed with caution, more so in fasting patients.

MeSH terms

  • Adult
  • Contraceptives, Oral / administration & dosage*
  • Contraceptives, Oral / adverse effects*
  • Dehydration / etiology
  • Fasting / adverse effects*
  • Fasting / physiology*
  • Female
  • Headache / etiology
  • Humans
  • Intracranial Thrombosis / epidemiology*
  • Intracranial Thrombosis / etiology*
  • Islam*
  • Prevalence
  • Protein S Deficiency / etiology
  • Retrospective Studies
  • Risk Factors
  • Saudi Arabia / epidemiology
  • Venous Thromboembolism / epidemiology*
  • Venous Thromboembolism / etiology*

Substances

  • Contraceptives, Oral