Vascular lesions in women taking oral contraceptives.

Abstract

Vascular lesions in 21 women who died of thrombosis while taking various oral contraceptives and in 21 women who died of thrombosis but who had not taken the pill were examined. Routine histologic sections were available and 7 other special stains were prepared from tissues fixed in formalin. Three types of lesions developed in the pill group. First three-layered thrombi with underlying structural changes were found in 19 cases consisting of an organized revascularized basal layer with accumulated collagen and in some cases macrophages; a zone of fibrin with ingrown fibroblasts between and an unorganized laminated thrombus above. The underlying structures were thickened disrupted and filled with acid mucopolysaccharide. The second type of lesion present in smaller pulmonary vessels in 4 cases was proliferation of the endothelium and intima into a network of papillary projections. The third type of lesion was found in only one case: nodular thickening of the intima media and adventia of the pulmonary artery. These women all suffered from locally formed thrombi which developed over a period of days or weeks indicating primary changes in the blood vessels rather than emboli as the cause of death.