Why the study?
Does estrogen-containing oral contraceptive use increase the risk of deep venous thrombosis in women undergoing major surgery?
Does estrogen-containing oral contraceptive use increase the risk of deep venous thrombosis in women undergoing major surgery?
Estrogen-containing oral contraceptives should be discontinued 4 weeks prior to major elective surgery to mitigate a twofold increased risk of postoperative deep venous thrombosis.
May warrant caution with estrogen OCs before major surgery; leaves open whether discontinuation reduces postoperative DVT.
This article on oral contraceptive (OC) use in relation to surgery recommends that estrogen-containing contraceptives should be discontinued 4 weeks before major elective surgery and started again at the 1st menses occurring at least 2 weeks after the procedure. After major surgery the relative risk of deep venous thrombosis is about 2 in users of estrogen-containing OCs compared with nonusers. The risk is greatest after major orthopedic abdominal and cancer surgery or any surgery that entails a hypotensive anesthetic. The excess risk of deep venous thrombosis appears to be unrelated to duration of OC use and reverts to normal within less than 1 month. This policy implies that women must be given at least 1 months advance notice of their admission. Special attention must be given to the risk of unwanted pregnancy when OC use is discontinued in anticipation of surgery. The couple should be helped to organize alternate means of contraception during this interval.
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John Guillebaud (1985) studied this question.
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