Patient N.T.H. (45 years old), a garment worker, has a history of using combined birth control pills (28 tablets) continuously for more than 10 years. On the day of admission, while working normally, she suddenly had severe difficulty breathing, chest pain and dizziness.
The family quickly took her to the Emergency Department, People's Hospital 115. Here, the doctor on duty recorded the patient in a state of low blood pressure, showing signs of severe shock. Cardiography and ultrasound shows that the image suggests right heart acute overload, a common sign of severe acute pulmonary fibrosis. Immediately, the patient was transferred to the Intensive Care and Anti-Poison Department (HSTC&CD) for intensive treatment, expected to have ECMO intervention if necessary.
After an interdisciplinary consultation at the Department ofTC and PCD, the diagnosis was made: high-risk congestion shock due to pulmonary embolism, thrombosis of the veins on both sides, and a risk factor of long-term combined use of birth control pills. In addition, the patient's practice of sitting next to a sewing machine for a long time also contributes to the risk of venous thrombosis and pulmonary embolism.
The HSTC&CD general practitioner decided to use an emulsion drug to dissolve the blood clot that was blocking the pulmonary blood vessels. After receiving the drug for 1 hour, the patient began to recover significantly: more alert, no longer having difficulty breathing, had a lighter chest, improved blood pressure, and had a significant reduction in the dose of vasopressors. A follow-up chest ultrasound showed that heart function had to improve significantly.
Up to now, the patient has almost returned to normal, breathing phong-ponetally, blood pressure is stable, no need for vasopressors and continues to use anticoagulants. The patient continued to be closely monitored at theTC&CD department to optimize the management of thrombosis before being discharged from the hospital. At the same time, the patient will also be examined by a Obstetrician and Gastroenterologist to be advised on another contraceptive method with less risk of thrombosis.
According to doctors at People's Hospital 115, combined contraceptives (containing estrogen and progestin) are one of the most popular and effective contraceptives. However, many studies have shown that estrogen in drugs can increase the risk of formation of deep vein thrombosis and pulmonary embolism, especially in women who have long-term use, smoke, obesity or have cardiovascular disease.
Currently, in addition to combined contraceptives, women can choose many other contraceptive methods with higher safety levels, depending on their health condition.
birth control pills only contain progestin: daily pills, birth control pills or hormonal birth control pills. Because it does not contain estrogen, the risk of thrombosis is significantly lower.
Copper birth control: does not affect the blood clotting system, suitable for women at risk of thrombosis or contraindications for hormones.
Rubber covers: are both effective in preventing pregnancy and preventing sexually transmitted diseases.
Injecting progestin, male/female hygiene or safe dating method: depending on personal needs and conditions.
