The Combined Vaginal Contraceptive Ring, NuvaRing, and Cerebral Venous Sinus Thrombosis: A Case Report and Review of the Literature

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• 作者：Christian Kolacki ; MD ; Vito Rocco ; MD ; FACEP ; FAAEM
• 关键词：NuvaRing ; complications ; combined vaginal contraceptive ring ; central venous sinus thrombosis
• 刊名：Journal of Emergency Medicine
• 出版年：2012
• 期刊代码：156_07364679
• 类别：med
• 出版时间：April, 2012
• 卷：42
• 期：4
• 页码：413-416
• 文件大小：159 K

摘要

Background

Combined oral contraceptives are known to confer a risk of venous thromboembolism, including cerebral venous sinus thrombosis (CVST), to otherwise healthy women. NuvaRing (Organon USA, Inc., Roseland, NJ) is a contraceptive vaginal ring that delivers 120 渭g of etonogestrel and 15 渭g of ethinyl estradiol per day. Its use has been associated with rare venous thromboembolic events, but few cases of CVST associated with NuvaRing have been reported.

Objective

To describe聽a case that illustrates the increased risk of CVST associated with use of NuvaRing. We describe the case of a NuvaRing user who presented to our emergency department with a headache, who was diagnosed with CVST.

Conclusion

Evidence suggests that NuvaRing has at least as much prothrombotic potential as combined oral contraceptives. Thus, emergency physicians should suspect serious venous thromboembolic events, including CVST, deep venous thrombosis, and pulmonary embolism, in NuvaRing users in the proper clinical setting.