Women receiving oral contraceptives may rarely develop arterial or venous thrombosis. The presence of historical or coagulation test findings may identify a woman who is at greater risk for thrombosis and who should receive an alternative contraceptive method. The authors are from Hospital La Fe in Valencia, Spain.


Patients who should avoid oral contraceptives and who should employ alternative contraceptive measures:

(1) a patient with a previous history of a thrombotic event

(2) a patient with a strong family history for thrombotic events


In a woman whose past history is unclear or whose familiar history for thrombosis is uncertain, then the patient should be screened for:

(1) factor S deficiency

(2) factor V Leiden (using activated protein C resistance)

(3) prothrombin G20210A

Although not listed by the authors, I would also screen for factor C and antithrombin III deficiency


If the person shows a deficiency in one or more of these factors, then oral contraceptive agents should not be used.


If a woman develops a thrombotic event while on oral contraceptives:

(1) the oral contraceptive therapy should be stopped

(2) she should be switched to an alternative contraceptive method

(3) she should be evaluated for thrombophilic defect


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