Implications of heterozygous factor V Leiden or prothrombin G20210A in nonpregnant adults

Any test results that impact clinical management and were not performed in a CLIA-certified or equivalent laboratory (such as from DTC testing or research) should be repeated in a CLIA-certified or equivalent laboratory. Risks of VTE with each thrombophilia, nuances of individualized management decisions, and recommendations from clinical practice guidelines are discussed in UpToDate. Some individuals may have additional risk factors for VTE other than hereditary thrombophilia. Refer to UpToDate for additional evaluations and interventions to reduce risk and for pregnancy and postpartum recommendations.

CEE: conjugated equine estrogen; CLIA: Clinical Laboratory Improvement Amendments; DTC: direct-to-consumer; E2: estradiol; EE: ethinyl estradiol; FVL: factor V Leiden; IM: intramuscularly; IUD: intrauterine device; PGM: prothrombin G20210A mutation; SC: subcutaneously; SERM: selective estrogen receptor modulators; VTE: venous thromboembolism.

* Use a low threshold for pharmacologic VTE prophylaxis in individuals who are heterozygous for FVL or PGM and have a positive family history of VTE (or a personal history of VTE and not receiving anticoagulation) in other settings such as:

Minor provoking risk factors (infection, immobility)
Pregnancy and postpartum, if other risk factors are present such as bedrest, cesarean delivery, or other surgery

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Implications of heterozygous factor V Leiden or prothrombin G20210A in nonpregnant adults