Thrombophilias: diagnosis and treatment of thrombophilia relating to contraception and pregnancy.

The thrombogenicity of oral contraceptives (OCs) has been known since the 1960s. The thrombotic risk remains increased even with the third-generation preparations containing low-dose estrogen and a progesterone. Thromboembolic disorders are a leading cause of maternal morbidity and mortality during pregnancy and puerperium in Western countries. Women with thrombophilic conditions are even more prone to hypercoagulability when using hormone therapy, or during pregnancy and puerperium. At present, it is not recommended that all OC users or pregnant women be routinely screened for thrombophilic abnormalities. The usefulness of testing for these disorders in the presence of multiple thrombotic risk factors should be considered on an individual basis. Anticoagulant treatment may be advised for selected patient populations.