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Effect of Progesterone and Synthetic Progestins on Whole Blood Clot Formation and Erythrocyte Structure

Published online by Cambridge University Press:  08 May 2017

Albe C. Swanepoel ,
Odette Emmerson  and
Etheresia Pretorius
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Abstract

Combined oral contraceptive (COC) use is a risk factor for venous thrombosis (VT) and related to the specific type of progestin used. VT is accompanied by inflammation and pathophysiological clot formation, that includes aberrant erythrocytes and fibrin(ogen) interactions. In this paper, we aim to determine the influence of progesterone and different synthetic progestins found in COCs on the viscoelasticity of whole blood clots, as well as erythrocyte morphology and membrane ultrastructure, in an in vitro laboratory study. Thromboelastography (TEG), light microscopy, and scanning electron microscopy were our chosen methods. Our results point out that progestins influence the rate of whole blood clot formation. Alterations to erythrocyte morphology and membrane ultrastructure suggest the presence of eryptosis. We also note increased rouleaux formation, erythrocyte aggregation, and spontaneous fibrin formation in whole blood which may explain the increased risk of VT associated with COC use. Although not all COC users will experience a thrombotic event, individuals with a thrombotic predisposition, due to inflammatory or hematological illness, should be closely monitored to prevent pathological thrombosis.

Keywords

progestinscombined oral contraceptiveserythrocytesvenous thrombosiseryptosis
Type
Biological Science Applications
Information
Microscopy and Microanalysis , Volume 23 , Issue 3 , June 2017 , pp. 607 - 617
Copyright
© Microscopy Society of America 2017 

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