UKMEC valvular heart disease — DFSRH MCQ

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HardUKMECUKMEC valvular heart diseaseDFSRH

A 32-year-old with mechanical mitral valve replacement on warfarin requests the combined vaginal ring for heavy periods. INR is 2.8 and she has migraine without aura. What is the UKMEC category for CHC?

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Correct answer: E — UKMEC 4

Complicated valvular heart disease, including mechanical valves and anticoagulation, makes CHC an unacceptable risk because of thrombosis and cardiovascular complications. Therapeutic INR does not make oestrogen-containing contraception safe. Bleeding control should be approached with safer alternatives and cardiology/haematology input if needed.

Reference: FSRH UKMEC; FSRH Combined Hormonal Contraception