akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2021.205akusherstvo-971Research ArticleREVIEW ARTICLESНАУЧНЫЕ ОБЗОРЫCerebral circulation disorders in women using combined oral contraceptivesНарушения мозгового кровообращения у женщин при использовании комбинированных оральных контрацептивовhttps://orcid.org/0000-0002-6524-3965АндрееваМ. Д.AndreevaM. D.

Андреева Маргарита Дарчоевна – доктор медицинских наук, профессор, доцент кафедры акушерства, гинекологии и перинатологии 

Scopus Author ID: 57200068605

350063 Краснодар, ул. Митрофана Седина, д. 4

Margarita D. Andreeva – MD, Dr Sci Med, Professor, Associate Professor, Department of Obstetrics, Gynecology and Perinatology

Scopus Author ID: 57200068605

4 Mitrofana Sedina Str., Krasnodar 350063

https://orcid.org/0000-0003-0590-8483НовосартянМ. Г.NovosartyanM. G.

Новосартян Маргарита Геннадиевна – аспирант кафедры акушерства, гинекологии и перинатологии 

350063 Краснодар, ул. Митрофана Седина, д. 4

Margarita G. Novosartyan – MD, Postgraduate Student, Department of Obstetrics, Gynecology and Perinatology

4 Mitrofana Sedina Str., Krasnodar 350063

novosartyan89@mail.ruhttps://orcid.org/0000-0002-4564-8439СамбуроваИ. В.SamburovaN. V.

Самбурова Наталья Викторовна – кандидат медицинских наук, доцент кафедры патофизиологии Института клинической медицины 

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4

Natalia V. Samburova – MD, PhD, Associate Professor, Department of Pathophysiology, Institute of Clinical Medicine

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991

https://orcid.org/0000-0002-5947-5014ХаманиИ. В.KhamaniI. V.

Хамани Инесса Васильевна – кандидат медицинских наук, доцент кафедры акушерства и гинекологии Клинического института детского здоровья имени Н.Ф. Филатова 

119991 Москва, ул. Большая Пироговская, д. 2, стр. 4

Inessa V. Khamani – MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, Filatov Clinical Institute of Children’s Health

2 bldg. 4, Bolshaya Pirogovskaya Str., Moscow 119991

ФГБОУ ВО «Кубанский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияKuban State Medical University, Health Ministry of Russian FederationRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияSechenov UniversityRussian Federation202104052021152173181Copyright © Andreeva M.D., Novosartyan M.G., Samburova N.V., Khamani I.V., 20212021Андреева М.Д., Новосартян М.Г., Самбурова И.В., Хамани И.В.Andreeva M.D., Novosartyan M.G., Samburova N.V., Khamani I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/971

The study is aimed at using combined oral contraceptives (COCs) and subsequent risk of developing cerebral circulation disorders (CCD), which is posed at the fine border between gynecology, hemostasiology and neurology. We discuss risk factors for thrombotic complications occurring upon COCs administration, pathogenetic mechanisms behind CCD, a COCs impact on hemostasis system, and their relation to risk of developing diverse stroke types. Inherited and acquired thrombophilia are discussed as one of the most important factors determining elevated CCD risk related to COCs use. We provide a detailed description of most thrombogenic genetic polymorphisms such as mutated Factor V Leiden gene, prothrombin G20210А gene etc., their role in stroke development, including conditions for COCs use. Special emphasis is made on insights into inherited and acquired АDАMTS-13 deficiency as well as antiphospholipid syndrome as factors contributing to stroke in females receiving hormonal contraceptives.

Статья посвящена теме использования комбинированных оральных контрацептивов (КОК) и проблеме риска нарушений мозгового кровообращения (НМК), связанного с приемом этих препаратов. Имеет тонкую грань между гинекологией, гемостазиологией и неврологией. Обсуждаются факторы риска тромботических осложнений при применении КОК, патогенетические механизмы нарушения церебрального кровотока, влияние гормональных контрацептивов на систему гемостаза, связи их использования с риском развития различных видов инсультов. Как один из наиболее важных факторов, определяющих повышенный риск НМК при приеме КОК, рассмотрена генетическая и приобретенная тромбофилия. Подробно описаны такие наиболее тромбогенные генетические полиморфизмы как мутация фактора V Лейден, полиморфизм гена протромбина G20210А и другие, их роль в развитии инсультов, включая условия применения КОК. Акцентировано внимание на наследственном и приобретенном дефиците АDАMTS-13 и антифосфолипидном синдроме как факторах, способствующих развитию инсульта у женщин, использующих гормональные методы контрацепции.

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The authors declare that there are no conflicts of interest present.