Relevant bibliographies by topics / Contraception – Failures

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Academic literature on the topic 'Contraception – Failures'

Author: Grafiati
Published: 4 June 2021
Last updated: 1 February 2022

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Journal articles on the topic "Contraception – Failures"

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Goulard, Hélène, Caroline Moreau, Fabien Gilbert, Nadine Job-Spira, and Nathalie Bajos. "Contraceptive failures and determinants of emergency contraception use." Contraception 74, no. 3 (September 2006): 208–13. http://dx.doi.org/10.1016/j.contraception.2006.03.007.

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WANG, DUOLAO, HONG YAN, and ZHONGHUI FENG. "ABORTION AS A BACKUP METHOD FOR CONTRACEPTIVE FAILURE IN CHINA." Journal of Biosocial Science 36, no. 3 (April 21, 2004): 279–87. http://dx.doi.org/10.1017/s0021932003006217.

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Contraceptive failure rates for modern methods including sterilization are reported to be high in China, but little is known about the consequence of contraceptive failure and characteristics of women who decide to have an abortion if a contraceptive failure occurs. Using 6225 contraceptive failures from the 1988 Chinese Two-per-Thousand Fertility Survey, this study examines the resolution of contraceptive failure and assesses the impact of some women’s sociodemographic characteristics on the decision to terminate contraceptive failure in abortion. This study has three important findings: (1) The abortion rate was 50·1%, 75·3% and 80·2% for IUD, condom and pill failures, respectively; (2) The abortion rates differed by contraceptive method and women’s social and demographic characteristics. In particular, a woman with just one child was most likely to have the contraceptive failure aborted; (3) Some women experienced repeated abortions because of contraceptive failure. The results suggest that abortion was a backup method if contraception failed in China and the correlates of aborting an unwanted pregnancy reflect the strong impact of the Chinese family planning programme.
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Parvin, Mosammat Bilkis, Kazi Sahnaz Begum, Naseem Jahan, and Hasina Sultana. "Tubal Ectopic Pregnancy after 11 Years of Bilateral Tubal Ligation." Northern International Medical College Journal 7, no. 1 (November 16, 2015): 119–20. http://dx.doi.org/10.3329/nimcj.v7i1.25707.

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Tubal ligation is a well excepted method of contraception. Permanent contraception by tubal ligation is one of the most commonly used contraceptive methods in United States, also most popular form of contraception worldwide. Although pregnancy after ligation is uncommon, it can occur and may be ectopic. Surprisingly, failures are not limited to the first year or two but continued to appear even after many years during follow up. In this paper we report a case of ectopic pregnancy in a patient who underwent bilateral tubal ligation11years ago during caesarean delivery for contraception.Northern International Medical College Journal Vol.7(1) Jul 2015: 119-120
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Pfitzer, Anne, Jacqueline Wille, Jonesmus Wambua, Stacie C. Stender, Molly Strachan, Christine Maricha Ayuyo, Timothy F. Kibidi Muhavi, Valentino Wabwile, Supriya D. Mehta, and Elizabeth Sasser. "Contraceptive implant failures among women using antiretroviral therapy in western Kenya: a retrospective cohort study." Gates Open Research 3 (January 14, 2020): 1482. http://dx.doi.org/10.12688/gatesopenres.12975.2.

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Background: Women living with HIV have the right to choose whether, when and how many children to have. Access to antiretroviral therapy (ART) and contraceptives, including implants, continues to increase in Kenya. Studies have reported drug-drug interactions leading to contraceptive failures among implant users on ART. This retrospective record review aimed to determine unintentional pregnancy rates among women 15-49 years of age, living with HIV and concurrently using implants and ART in western Kenya between 2011 and 2015. Methods: We reviewed charts of women with more than three months of concurrent implant and ART use. Implant failure was defined as implant removal due to pregnancy or birth after implant placement, but prior to scheduled removal date. The incidence of contraceptive failure was calculated by woman-years at risk, assuming a constant rate. Results: Data from 1,152 charts were abstracted, resulting in 1,190 implant and ART combinations. We identified 115 pregnancies, yielding a pregnancy incidence rate of 6.32 (5.27–7.59), with 9.26 among ETG and 4.74 among LNG implant users, respectively. Pregnancy incidence rates did not differ between EFV- and NVP-based regimens (IRR=1.00, CI: 0.71-1.43). No pregnancies were recorded among women on PI-based regimens, whereas pregnancy rates for efavirenz and nevirapine-containing regimens were similar, at 6.41 (4.70–8.73) and 6.44 (5.13–8.07), respectively. Pregnancy rates also differed significantly by implant type, with LNG implant users half as likely to experience pregnancy as ETG implant users (0.51, CI: 0.33-0.79, p>0.01). Conclusions: Our findings highlight the implications of drug-drug interaction on women’s choices for contraception.
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Rani, Reena, Rachna Sharma, and Charu Kohli. "Female sterilization failure, consequences and further contraception: a review of cases over ten years." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 9, no. 10 (September 25, 2020): 4032. http://dx.doi.org/10.18203/2320-1770.ijrcog20204282.

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Objective: To study the socio-demographic profile and etiological factors responsible for failure of tubal ligation. Their outcome and further adopted methods of contraception.Methods: This was a retrospective observational study done in a tertiary care centre from January 2009 to December 2018. All cases who came with sterilization failure were reviewed including their demographic patterns, previous methods used and the contraception choices adopted after procedural failure.Results: Over a period of ten years, out of a total of 157 cases of sterilization failure 43.33% (n=68) were laparoscopic interval ligation, 42.60% (n=67) were laparoscopic ligation with termination of pregnancy, 10.20% (n=16) were sterilization done along with lower segment cesarean section and 1.9% (n=3) were mini-laparotomy (minilap) done in postpartum period. Only 63.05% (n=99) got repeat sterilization procedure done despite previous failure. Out of 157 cases, in 50.9% (n=80) recanalization was found, tuboperitoneal fistula was responsible in 5.7% (n=9) women, slipped fallope ring was found in 5.7% (n=9) women, wrong application of fallope ring was seen in 1.9% (n=3) and 35.6% (n=56) did not opted for religation.Conclusion: Failures of sterilization procedures do exist especially in laparoscopic ligation. Counseling prior to adoption of this method, risk of failure and other noninvasive options of contraception must be discussed.
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Pfitzer, Anne, Jacqueline Wille, Jonesmus Wambua, Stacie C. Stender, Molly Strachan, Christine Maricha Ayuyo, Timothy F. Kibidi Muhavi, Valentino Wabwile, Supriya D. Mehta, and Elizabeth Sasser. "Contraceptive implant failures among women using antiretroviral therapy in western Kenya: a retrospective cohort study." Gates Open Research 3 (June 4, 2019): 1482. http://dx.doi.org/10.12688/gatesopenres.12975.1.

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Background: Women living with HIV have the right to choose whether, when and how many children to have. Access to antiretroviral therapy (ART) and contraceptives, including implants, continues to increase due to a multitude of efforts. In Kenya, 4.8% of adults are living with HIV, and in 2017, 54% were receiving an efavirenz-based ART regimen. Meanwhile, 16.1% of all Kenyan married (and 10.4% of unmarried) women used implants. Studies have reported drug interactions leading to contraceptive failures among implant users on ART. This retrospective record review aimed to determine unintentional pregnancy rates among women 15-49 years of age, living with HIV and concurrently using implants and ART in western Kenya between 2011 and 2015. Methods: We reviewed charts of women with more than three months of concurrent implant and ART use. Implant failure was defined as implant removal due to pregnancy or birth after implant placement, but prior to scheduled removal date. The incidence of unintended pregnancy was calculated by woman-years at risk, assuming a constant rate. Results: Data from 1,152 charts were abstracted, resulting in 1,190 implant and ART combinations. We identified 115 pregnancies, yielding a pregnancy incidence rate of 6.32 (5.27–7.59), with 9.26 among ETG and 4.74 among LNG implant users, respectively. No pregnancies were recorded among women on non-NNRTI-based regimens, whereas pregnancy rates for efavirenz and nevirapine-containing regimens were similar, at 6.41 (4.70–8.73) and 6.44 (5.13–8.07), respectively. Conclusions: Our findings highlight the implications of drug interaction on women’s choices for contraception.
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Rahmatiqa, Chamy, Shinta Prawitasari, and Siswanto Agus Wilopo. "Contaceptive use spacing after childbirth with contraception failure: IDHS 2012 analysis." Berita Kedokteran Masyarakat 32, no. 8 (March 29, 2018): 273. http://dx.doi.org/10.22146/bkm.9356.

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Contraceptive use after childbirth and contraception failure: an analysis of Indonesia Demographic Health Survey 2012PurposeThis research aimed to evaluate the use of contraception after childbirth with contraception failure. MethodsThis research was an observational study using IDHS 2012 with a retrospective cohort design. Married women who got pregnant while using contraceptives were the unit of analysis. Statistical analysis used survival analysis with stratified Cox Regression methods.ResultsAnalysis showed a higher failure rate in the traditional contraceptive methods such as coitus interruptus and periodic abstinence. The failure rate of the contraceptive method implant in Indonesia was higher by 10 times the global failure rate. Women who had used contraceptive for 33-48 weeks and >48 weeks after childbirth had higher risk of pregnancy with contraceptive failure (respectively HR=1.25; 95% CI: 0.63-2.47 and 1.91; 95% CI: 1-3.67), respectively. Other factors influencing the contraceptive failure were age and met or unmet needs.ConclusionContraceptive use after childbirth is associated with contraceptive failure among woman of childbearing age in Indonesia. Providers of contraceptive implants may introduce additional variations of implantable contraceptives in Indonesia and are supported by qualified health personnel.
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Stuleva, N. S., A. V. Vorobiev, and E. A. Orudzhova. "A case of mesenteric vein thrombosis developed in the first trimester of pregnancy after in vitro fertilization and embryo transfer in a patient with antiphospholipid syndrome." Obstetrics, Gynecology and Reproduction 12, no. 4 (February 26, 2019): 72–78. http://dx.doi.org/10.17749/2313-7347.2018.12.4.072-078.

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Combined thrombophilia is known as a probable cause of recurrent in vitro fertilization (IVF) failures. The present clinical case demonstrates the importance of considering the possibility of inherited or acquired thrombophilia in patients under the preparation for IVF. Thromboses of rare locations (hepatic vein, splenic vein, mesenteric vein, ovarian vein, retinal vein, cerebral vein, portal vein, axillary and subclavian vein) are life-threatening conditions. Most often thrombosis of atypical location develops in patients with inherited hemostatic defects, e.g. genetic thrombophilia. Such thromboses can also result from acquired abnormalities of hemostasis, which include antiphospholipid syndrome, pregnancy-associated hypercoagulability, IVF, oral contraception, or ovarian hyper-stimulation within IVF procedures.
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Rahmatiqa, Chamy, Siswanto Agus Wilopo, and Shinta Purwasari. "Failure contraception in Indonesia: IDHS 2012 data analysis." International Journal Of Community Medicine And Public Health 6, no. 6 (May 27, 2019): 2295. http://dx.doi.org/10.18203/2394-6040.ijcmph20192287.

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Background: Contraception prevalence rate (CPR) increased from the year 1991 is 50% to 62% in 2012 but Totak fertility rate (TFR) was little changed at data IDHS 2002-2003, 2007, and 2012 that is 2.6. Of IDHS 2007, the failure of contraception reflects the result in the unwanted pregnancies that can result in high maternal mortality and morbidity of the baby in the year 2012. The research aims to assess the failure of the contraceptive couples of childbearing age in Indonesia.Methods: Research was the observational study design with a cohort-retrospective. Researchers analyzed longitudinal data using calendar data IDHS 2012. The sample was 10.250 women of childbearing age ever married aged 15-49 years and the use of contraceptives. The analysis of contraceptive failure based on the predictor performed with the cox proportional hazard model by using curves Kaplan-Meier.Results: The most effective contraceptives found that the Implant (0.56) and the IUD (0.75) this was a modern contraceptive. The failure rate of the most high was neither disconnected (8.93) and periodic abstinence (7.32) this is the traditional contraception. The injectable and the pill was the choice of the majority of the respondents. The failure rate of the most high according to modern methods of contraception was injectables (35.67%), while the traditional method is neither disconnected (15.34%).Conclusions: The traditional method was the potential of failure compared to modern methods of contraception that may increase the unwanted pregnancy.
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Shete, Mahesh R., Prakash Kumar, Enu Anand, Jayakant Singh, and Manas Ranjan Pradhan. "Discontinuation of modern contraception methods due to side effects and method failure in India: an analysis using reproductive calendar data." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 10, no. 9 (August 26, 2021): 3462. http://dx.doi.org/10.18203/2320-1770.ijrcog20213469.

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Background: Contraceptive discontinuation for reasons other than the desire to get pregnant is a significant public health concern. This study aimed to understand the elaborated role of side effects and method failure behind modern reversible contraception method discontinuation among married women aged 15-49 years in India.Methods: The analysis was based on 142992 episodes of contraceptive use contributed by 90414 married women aged 15-49 years covered in the National family health survey-4 (2015-2016). Multivariate analyses, discontinuation rates using the multiple/single decrement life table and multi-level multinomial competing risk analyses were performed.Results: Discontinuation rate due to side effects within 12 months of use was highest for injectables (14.7%) and lowest for male condoms (3%) and due to method failure, it was highest for male condoms (3%) and lowest among IUD users (1.2%). Compared to women using IUD, those using pills had 2.3 times and 1.6 times the higher hazard of discontinuation due to method failure and side effects, respectively.Conclusions: The discontinuation rate of all selected methods was higher due to side effects than method failure. The high discontinuation rate of many contraceptive methods and the frequency of contraceptive failure suggest the need for strategies to promote improved contraceptive use following method selection. Improved quality of services through proper counselling of the potential contraceptive users would enhance informed choice, thus increasing modern contraception continuation among women in India.
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Dissertations / Theses on the topic "Contraception – Failures"

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Blankenship, Steve Ray. "Reconfiguring Memories of Honor: William Raoul's Manipulation of Masculinities in the New South, 1872-1918." Digital Archive @ GSU, 2007. http://digitalarchive.gsu.edu/history_diss/3.

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This dissertation examines how honor was fashioned in the New South by examining the masculine roles performed by William Greene Raoul, Jr. Raoul wrote his autobiography in the mid-1930s and in it he reflected on his life on the New South's frontier at the turn of the century as change came to the region in all aspects of life: politically, economically, socially, sexually, and racially. Raoul was an elite son of the New South whose memoirs, "The Proletarian Aristocrat," reveals a man of multiple masculinities, each with particular ways of retrieving his past(s). The paradox of his title suggests the parallel organization of Raoul's recollections. The "aristocrat" framed the events of a lifetime through a lens of honor, sustained by southern gentlemen who restrained masculine impulses on the one hand and avoided dependency on the other. Raoul the "proletarian" cast honor through an ideological retrospective whereby traumatic memories of disappointment and failure were re-fashioned through a distinctly politicized view constructed rather than recalled. Raoul's business failures led him to re-conceptualize masculine honor as a quality possessed more by the emerging working class than the rising commercial class. Memory operates in this project as more than mere methodology as assumptions about access to the past through memory are subordinated to an examination of the meaning of the memories rehearsed by Raoul. Raoul wrote his autobiography at a bittersweet moment in his life. While his personal fortune had been nearly wiped out by the stock market crash of October 1929, he clearly looked back on his career in the New South as a committed radical with delight as the Great Depression called into question the legitimacy of the capitalist system that he had long held responsible for his own professional failures in a variety of endeavors, from the cotton-mill industry to box-car building and from saw manufacturing to a practicing accountant. Raoul converted to Socialism in part to join what he regarded as society's most progressive and virile force. It is these two voices, the proletarian and the aristocrat, that are under examination here.
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Maja, Todd Mamutle Mavis. "Contraceptive practices in Northern Tshwane, Gauteng Province." Thesis, 2002. http://hdl.handle.net/10500/880.

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Unwanted and unintended pregnancies pose major reproductive health challenges to women throughout the world. Despite the availability of modern contraceptives, many women and men fail to use contraceptives effectively. This research focussed on reasons for not using contraceptives effectively in the Northern Tshwane area of the Gauteng Province of the Republic of South Africa (RSA). Structured interviews were conducted with 83 women and 71 men about their contraceptive practices. Age, religion, educational level and residential areas influenced clients' contraceptive practices. These results were categorised for adult males and females as well as for adolescent males and females. Adolescents encountered problems in accessing contraceptive services. Adult females knew most about traditional contraceptives, although men knew about some of these methods, and adolescents used some of them. All respondents could gain additional knowledge about modern contraceptives. The respondents' knowledge about · emergency contraceptives was extremely limited. Although most respondents knew about legalised choice on.termination of pregnancy (CTOP) services in the RSA, they did not know when nor how to access these services. Nurses working in contraceptive health services, revealed during a focus group discussion that a lack of resources (including shortages of malcondoms, contraceptive injections and oral contraceptives) hampered the quality of services that could be rendered. Of particular concern was the nonavailability of Norplant implants and female condoms. Nurses expressed a need for pecific national policy guidelines about supplying contraception to adolescents. Although most nurses knew about emergency contraceptives, they did not promote its use because they assumed that clients would misuse emergency contraceptives.instead of using contraceptives regularly. The nurses indicated that very few facilities offered CTOP services. The nurses regarded women who obtained repeated CTOPs to be misusing these services and suggested that limitations should be placed on the number-of times any woman could obtain such services. The negative attitudes of community members and of colleagues towards persons working in CTOP services caused hardships for them. Recommendations address ways in which contraceptive services could be improved.
Health Studies
D. Litt. et Phil. (Advanced Nursing Sciences)
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Sekgobela, Constance Balahliye. "Pregnancy-related challenges encountered by student nurses at the South African Military Health Services Nursing College." Thesis, 2008. http://hdl.handle.net/10500/727.

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This study identified pregnancy-related challenges encountered by student nurses at SAMHS Nursing College, with an aim of identify factors contributing to student nurses' pregnancies as well as finding ways to deal and minimize the rate of the pregnancies amongst the student nurses. Thirty (30) structured interviews were conducted with student nurses who were pregnant and those who delivered their babies during the period 2002 to 2007. It has been revealed that ignorance is the major contributing factor for student nurses' pregnancies, 63% of the pregnancies were not planned, 52% of the respondents related their pregnancies to risk taking as they engaged in unprotected sex without the use of contraceptives, and thus it was concluded that student nurses are engaging themselves in risk behaviours and also engaging in unsafe sexual practices. The study also found that student nurses face physical, social, emotional as well as academic problems during pregnancy and after the delivery of their babies. Student nurses should be encouraged to use condoms and other methods of contraception, coupled with educating them on life skills, provision of recreational facilities; provision of counseling and support services may be the tool to minimise the unplanned pregnancies.
Health Studies
(M.A.(Public Health ))
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Books on the topic "Contraception – Failures"

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Henry, Rebecca. Contraceptive practice in Quirino Province, Philippines: Experiences of side effects. Manila, Philippines: University of the Philippines, Population Institute, 2001.

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Henry, Rebecca Rose. Contraceptive practice in Quirino Province, Philippines: Experiences of side effects. Manila, Philippines: University of the Philippines, Population Institute, 2001.

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Christopher, Wright. Bangladesh, behavior change communications strategy for contraceptive security. [Dhaka]: Deliver Bangladesh, 2003.

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Curtis, Siân L. Determinants of contraceptive failure, switching, and discontinuation: An analysis of DHS contraceptive histories. Calverton, Md. (11785 Beltsville Dr., Suite 300, Calverton 20705): Macro International, 1997.

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Curtis, Siân L. Determinants of contraceptive failure, switching, and discontinuation: An analysis of DHS contraceptive histories. Calverton: Macro International, 1997.

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Perez, Aurora Esquivel. Contraceptive discontinuation, failure, and switching behavior in the Philippines. Calverton, Md: Macro International Inc., 1996.

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Christopher Tietze International Symposium on the Prevention and Treatment of Contraceptive Failure (1st 1985 Berlin, Germany). Prevention and treatment of contraceptive failure: In honor of Christopher Tietze. New York: Plenum Press, 1986.

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Laing, John E. Findings on contraceptive use effectiveness from the 1987 Thailand demographic and health survey. Honolulu, Hawaii: East-West Center, 1992.

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Lankenau, Anita. Obstinate embryo. Los Angeles, CA: Authors Unlimited, 1992.

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Landy, Uta, and S. S. Ratnam, eds. Prevention and Treatment of Contraceptive Failure. Boston, MA: Springer US, 1987. http://dx.doi.org/10.1007/978-1-4684-5248-8.

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Book chapters on the topic "Contraception – Failures"

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Rosenfield, Allan. "Contraception after Pregnancy Termination." In Prevention and Treatment of Contraceptive Failure, 197–200. Boston, MA: Springer US, 1986. http://dx.doi.org/10.1007/978-1-4684-5248-8_30.

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Senanayake, Pramilla. "Prevention of Contraceptive Failure—An Overview." In Prevention and Treatment of Contraceptive Failure, 21–25. Boston, MA: Springer US, 1986. http://dx.doi.org/10.1007/978-1-4684-5248-8_4.

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Faundes, Anibal. "Prevention of Contraceptive Failures with Hormonal Implants." In Prevention and Treatment of Contraceptive Failure, 39–43. Boston, MA: Springer US, 1986. http://dx.doi.org/10.1007/978-1-4684-5248-8_7.

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Lehfeldt, Hans. "Memorial Tribute to Dr. Christopher Tietze." In Prevention and Treatment of Contraceptive Failure, 1–3. Boston, MA: Springer US, 1986. http://dx.doi.org/10.1007/978-1-4684-5248-8_1.

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Hong, Sung-bong. "Utilization of Induced Abortion in Korea." In Prevention and Treatment of Contraceptive Failure, 61–65. Boston, MA: Springer US, 1986. http://dx.doi.org/10.1007/978-1-4684-5248-8_10.

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Viel, Benjamin. "Induced Abortion in Latin America: Impact on Health." In Prevention and Treatment of Contraceptive Failure, 67–72. Boston, MA: Springer US, 1986. http://dx.doi.org/10.1007/978-1-4684-5248-8_11.

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Bahl Dhall, Sudesh. "Training and Delivery of Abortion in India." In Prevention and Treatment of Contraceptive Failure, 73–77. Boston, MA: Springer US, 1986. http://dx.doi.org/10.1007/978-1-4684-5248-8_12.

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Mehlan, K. H. "Legal Abortions in Socialist Countries of Eastern Europe: An Epidemiological Review." In Prevention and Treatment of Contraceptive Failure, 79–82. Boston, MA: Springer US, 1986. http://dx.doi.org/10.1007/978-1-4684-5248-8_13.

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Ketting, Evert. "Medical Experience with Abortion after Legalization in Western Europe." In Prevention and Treatment of Contraceptive Failure, 83–88. Boston, MA: Springer US, 1986. http://dx.doi.org/10.1007/978-1-4684-5248-8_14.

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Singh, Kuldip, Osborn Viegas, and S. S. Ratnam. "The Effects of Legislation of Abortion on Maternal and Perinatal Outcome." In Prevention and Treatment of Contraceptive Failure, 89–98. Boston, MA: Springer US, 1986. http://dx.doi.org/10.1007/978-1-4684-5248-8_15.

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Conference papers on the topic "Contraception – Failures"

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Lowe, G. D. O. "EPIDEMIOLOGY AND RISK PREDICTION OF VENOUS THROMBOEMBOLISM." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1642965.

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Uses of epidemiology. Venous thromboembolism continues to be an important cause of death and disability in Western Countries. Its epidemiology may provide clues to etiology, e.g. the increased incidence in oral contraceptive users, and the low prevalence at autopsy in Central Africa or Japan compared to the U.S.A. A second use is the monitoring of time-trends: the diagnosis of pulmonary embolism increased during the 1970s, although the case fatality decreased. A third use is the identification and quantification of risk factors: these could be modified in the hope of prevention, or else used to select high risk groups for selective prophylaxis, e.g. during acute illness. Prevention is the only feasible approach to reducing the burden of venous thromboembolism, since most cases are not diagnosed, and since the value of current treatment is debatable.Case definition. Presents problems: clinical diagnosis is unreliable, and should if possible be supported by objective methods. Autopsy studies are performed on selected populations, at a decreasing rate; the frequency of thromboembolism depends on technique; and pathologists cannot be blinded and are open to bias. It can also be difficult to judge whether a patient dying with pulmonary embolism died from pulmonary embolism. 125I-fibrinogen scans indicate minimal disease, and now present ethical problems in screening due to risks of viral transmission. Venography is invasive and is not readily repeatable, which limits its use as a screening method. Plethysmography merits wider evaluation, since it is non-invasive, and sensitive to major thrombosis.Community epidemiology. Data on the community epidemiology are limited. The risk increases with age. When age is taken into account, there is little sex difference. Overweight in women, use of oral contraceptives and blood group A increase the risk: smoking, varicose veins, blood pressure, cholesterol and glucose do not, on current evidence. Long-term follow-up of patients with proven thromboembolism shows an increased risk of malignancy, hence occult cancer may also be a risk factor. Polycythaemia and certain congenital deficiencies (e.g. antithrombin III) are also well-recognised risk factors, although uncommon.Hospital epidemiology. Data on hospital epidemiology are derived largely from autopsy prevalence, and from short-term incidence of minimal thrombosis detected by 125I—fibrinogen scanning. Old, immobile and traumatised patients are most at risk. Previous thromboembolism, polycythaemia, antithrombin III deficiency, hip and leg fractures, elective hip and leg surgery, hemiplegia, paraplegia, and heart failure carry high risks, and merit consideration for routine prophylaxis. The risk in elective surgery precedes the operation, and increases with age, overweight, malignancy, varicose veins, non-smoking, and operative factors (duration, approach, general anaesthesia, intravenous fluids). Diabetics appear to have no extra risk. Combinations of clinical variables can be used to predict high risk groups for selective prophylaxis, but combination indices require further study. Laboratory variables may increase the predictability of deep vein thrombosis, but the results of published studies are conflicting, and the cost-effectiveness of laboratory prediction should be evaluated.
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