Algorithm for managing heterozygotes for factor V Leiden or prothrombin G20210A

This algorithm only applies to heterozygotes. Homozygotes or double heterozygotes (individuals who are heterozygous for more than one thrombophilia variant) generally have a greater increase in the risk of a first VTE than heterozygotes; they may require more aggressive prophylaxis and have a stronger indication for indefinite treatment if they develop a VTE. This algorithm does not address indications for thrombophilia testing. Refer to UpToDate for the indications for testing; the details of medical and surgical prophylaxis; and alternative options for contraception, reducing menstrual pain, and treatment of acne.

FVL: factor V Leiden; VTE: venous thromboembolism; DVT: deep vein thrombosis; PE: pulmonary embolism.

* Applies to estrogen-containing contraceptives for prevention of pregnancy or other indications (treatment of menstrual pain, acne). Must be balanced against the risk of unintended pregnancy, which also increases VTE risk. We feel most strongly about avoiding estrogens in individuals with a personal history of VTE and those with a strong family history of VTE. Options for alternative forms of contraception (or alternative treatments for menstrual pain or acne) should be provided. A progesterone-releasing intrauterine device or the mini-pill (progesterone only) do not increase VTE risk.

¶ Other risk factors include bedrest for preeclampsia, surgery, or cesarean delivery.

Graphic 123067 Version 6.0

خرید پکیج

Algorithm for managing heterozygotes for factor V Leiden or prothrombin G20210A