Thrombophilia test request protocol
Introduced May 2011
Clinical indications requiring testing
Clinical indications for which full thrombophilia testing will be performed are:
- Idiopathic venous thrombo-embolism in young patients (<45 years)
- Recurrent VTE
- Recurrent VTE despite adequate therapeutic anticoagulation
- VTE in context of family history of unprovoked VTE in a first degree relative
- Thrombosis in unusual sites (e.g. cerebral, mesenteric, portal)
- VTE in association with a history of thrombophlebitis
- Warfarin-induced skin necrosis
- Pregnancy complications such as pre-eclampsia, IUGR, placental abruption or recurrent miscarriage.
- There is no evidence currently to support anticoagulation in women with pregnancy complications and a positive hereditary thrombophilia. Trials are ongoing in this area. However, it is recognised that in routine practice management decisions are currently made in conjunction with thrombophilia testing.
Clinical settings not approved for testing
Thrombophilia screen will not be performed in the following clinical settings:
- Prior to prescription of COC in patients with a personal or family history of VTE. (Current British guidelines recommend avoidance of the COC in this setting regardless of the thrombophilia results.)
- Arterial thrombosis (Lupus testing is indicated in this setting)
A comment will appear on the test report when thrombophilia testing is not performed.
For thrombophilia testing requests beyond the clinical indications on this page please consult with a haematologist at Aotea Pathology or Wellington Public Hospital.