{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T03:47:58Z","timestamp":1782186478988,"version":"3.54.5"},"reference-count":14,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Estetrol\/drospirenone (E4\/DRSP) is a combined oral contraceptive noted for its minimal hemostatic impact compared to ethinyl estradiol\u2010based preparations. However, real\u2010world thrombotic risk data in patients with significant comorbidities remain limited. A woman in her early 40s with adenomyosis and menorrhagia was prescribed E4\/DRSP. Six weeks later, she developed acute left upper extremity weakness; imaging confirmed superior sagittal sinus thrombosis. She had severe iron deficiency anemia (hemoglobin 6.4\u2009g\/dL). Multiple overlapping risk factors\u2014including severe iron deficiency anemia with reactive thrombocytosis, adenomyosis, obesity, hypertension, and age over 40\u2014likely contributed synergistically, and the independent contribution of E4\/DRSP cannot be determined. She was treated with anticoagulation and transitioned to relugolix for adenomyosis management. Although E4\/DRSP has a favorable coagulation profile, thrombotic risk persists in women with adenomyosis and severe anemia. Pre\u2010prescription assessment including correction of anemia and consideration of estrogen\u2010free alternatives is warranted.<\/jats:p>","DOI":"10.1111\/jog.70366","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:08:38Z","timestamp":1780988918000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cerebral Venous Sinus Thrombosis Occurring During Estetrol\/Drospirenone Combined Oral Contraceptive Use in a Woman With Multiple Thrombotic Risk Factors: A Case Report"],"prefix":"10.1111","volume":"52","author":[{"given":"Mariko","family":"Nakahara","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Juntendo University Nerima Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuhito","family":"Fuse","sequence":"additional","affiliation":[{"name":"Department of Neurology Juntendo University Nerima Hospital  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