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

• Published in: Saudi medical journal Vol. 41; no. 10; pp. 1063 - 1069
• Main Authors: AlSheef, Mohammed, Alotaibi, Mastourah, Zaidi, Abdul Rehman Z, Alshamrani, Areej, Alhamidi, Aroub, Zaidi, Syed Ziauddin A, Alanazi, Noor, Alhathlool, Sarah, Alarfaj, Ohoud, AlHazzaa, Mohammed, Kullab, Ghaydaa, Alboghdadly, Amany, Abu-Shaheen, Amani
• Format: Journal Article
• Language: English
• Published: Saudi Arabia Saudi Medical Journal 01-10-2020; Prince Sultan Military Medical City (PSMMC)
• Subjects: Adult; Anticoagulants; Birth control; Contraceptives, Oral - administration & dosage; Contraceptives, Oral - adverse effects; Dehydration (Physiology); Dehydration - etiology; Epidemiology; Fasting; Fasting - adverse effects; Fasting - physiology; Female; Headache - etiology; Health aspects; Humans; Intracranial Thrombosis - epidemiology; Intracranial Thrombosis - etiology; Islam; Islamic culture; Medical research; Oral contraceptives; Original; Prevalence; Protein S Deficiency - etiology; Ramadan; Retrospective Studies; Risk Factors; Rivaroxaban; Saudi Arabia - epidemiology; Thrombophlebitis; Thrombosis; Venous Thromboembolism - epidemiology; Venous Thromboembolism - etiology; Womens health; Saudi Arabia; Iran
• ISSN: 0379-5284; 1658-3175
• DOI: 10.15537/smj.2020.10.25397

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.