Oral contraceptive (OC) use is a risk factor for the development of deep venous thromboses (DVT) in adolescents, particularly for those patients undergoing surgery. Adolescents have received little attention in the literature on this subject. We describe a 17-year-old female who developed a DVT while receiving OCs at the time of elective surgery. We recommend that adolescent females undergoing elective surgery discontinue OCs at least 1 month before and after the surgery and attendant immobilization.
PIP: Oral contraceptive (OC) use is a risk factor for developing deep venous thromboses (DVT) in adolescents, especially among those undergoing surgery. OCs increase venous distensibility, affect the intimal proliferation of venous walls, and increase blood coagulability. All of these factors affect thrombus formation. Adolescent females frequently use OCs to meet contraceptive and noncontraceptive ends. This paper describes the development of a DVT in a 17-year old female presenting for elective surgery to correct recurrent shoulder subluxation. Up to the day of admission, this patient used OCs containing 35 or 50 mcg ethinyl estradiol and 1.0 mcg norethindrone. She denied having chest pain, leg pain, hemoptysis, and headaches. There was no history of extended bed rest before surgery and no family history of thromboembolic disease. The operation was conducted without event. Nevertheless, the patient developed a DVT in the left popliteal vein. which was resolved with supportive measures and anticoagulation therapy using heparin and coumadin. Adolescent females using OCs should not take contraceptive pills for at least 1 month before and after elective surgery and attendant immobilization. Contraceptive counseling should be provided for these youths to help them adopt another form of contraception over this minimal 2-month period. Associated literature is briefly reviewed.