From the Guidelines
For female prep, I strongly recommend a comprehensive approach that includes a thorough medical history, discussion of reproductive life plan, and assessment of contraceptive needs, as outlined in the most recent guidelines 1. When preparing for a female patient, it is essential to consider the following key points:
- Obtain a thorough medical history, including menstrual history, to identify safe contraceptive methods 1
- Discuss the patient's reproductive life plan, including pregnancy intentions and timeline, to provide personalized care 1
- Assess the patient's contraceptive needs and offer FDA-approved methods, as well as counseling on emergency contraception 1
- Evaluate the patient's overall health, including chronic conditions, lifestyle risks, and immunization status, to reduce maternal and fetal morbidity and mortality 1
- Consider the patient's mental health and provide individualized treatment, as mood and anxiety disorders are prevalent in women of reproductive age 1 By following these guidelines, healthcare providers can provide comprehensive and personalized care to female patients, reducing the risk of complications and improving overall health outcomes. Key aspects of preconception care include:
- Taking a daily supplement of 400 to 800 mcg of folic acid, starting before conception, to reduce the risk of neural tube defects 1
- Consuming a balanced diet of folate-rich foods to support fetal development 1
- Addressing lifestyle risks, such as smoking, hypertension, and diabetes, to prevent pregnancy complications 1
- Evaluating immunization status annually to ensure protection against infectious diseases 1
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Preoperative Care for Females
- There is limited information available on preoperative care specifically for females in the provided studies.
- However, a study on preoperative care in general provides guidance on how to prepare patients for surgery, including physical and psychosocial care 2.
- This study suggests that preoperative care should begin when the patient is booked for surgery and end with their transfer to the theatre or surgical suite.
- It also highlights the importance of patient information and education during the preoperative period.
Medication Interactions
- Several studies examine the interaction between nonsteroidal anti-inflammatory drugs (NSAIDs) and oral anticoagulants (OACs), which may be relevant to preoperative care for females taking these medications.
- These studies suggest that concomitant use of NSAIDs and OACs increases the risk of bleeding, including gastrointestinal bleeding and major bleeding 3, 4, 5.
- One study found that the risk of bleeding was higher when vitamin K antagonists (VKAs) were used with NSAIDs compared to direct OACs (DOACs) 3.
- Another study found that the risk of clinically relevant and major bleeding was increased when NSAIDs or aspirin were used with anticoagulant therapy in patients with venous thromboembolism 4.
Clinical Outcomes
- A systematic review examined the clinical outcomes of aspirin interaction with other non-steroidal anti-inflammatory drugs, including the effect on cardiovascular risk 6.
- The review found that aspirin maintains its cardioprotective effect in the presence of certain NSAIDs, such as naproxen, ibuprofen, meloxicam, and rofecoxib.
- However, another study found that coprescribing NSAIDs and OACs increases the risk of gastrointestinal bleeding, major bleeding, stroke, and systemic embolism 5.