A warning has been issued to woman on the contraceptive pill, and doctors prescribing it, after two woman died in the same month from similar complications.
Coroner Alex Ho, in Auckland in New Zealand, released findings into the tragedies this week that recommended women should be counselled on the risks of venous thromboembolism, with both woman having unknown blood clotting conditions.
One of the women, Georgia O’Neill, a 24-year-old makeup artist, was found dead in her room at her shared flat in Mount Roskill Auckland by her housemate in September 2021.
Ms O’Neill earlier that day had texted her housemate and her father saying she wasn’t feeling well and had pain in her lower back running down her left leg. She told her housemate the pain made her want to throw up.
Coroner Ho said Ms O’Neill was unaware she had a condition known as Factor V Leiden mutation which increases the risk of deep vein thrombosis (DVT) or pulmonary embolism (PE) to those taking the pill by 35 times.
For those without the condition who take the pill the risk is about three-to-fourfold.
Coroner Alexander Ho said women should be counselled on the increased risk of blood clots while using the combined contraceptive pill and on the symptoms they should not ignore
Dr Eileen Merriman, clinical director of haematology and lead thrombosis clinician at Te Whatu Ora Waitematā, said there is no benefit to routinely screen for Factor V Leiden before patients go on the contraceptive.
This is because most people who developed a DVT or PE do not have the thrombophilic mutation.
‘The absence of a positive test may therefore falsely reassure those with a family history of venous thromboembolism where concomitant risk factors might be present,’ Dr Merriman said, reports the NZ Herald.
In coroner Ho’s recommendations he said that all woman who took the combined contraceptive pill and particularly those with a family history of venous thromboembolism should be vigilant about monitoring for symptoms and not dismiss them.
In the case of DVT, symptoms include leg pain in the thigh or calf, swelling, skin that is hot to the touch and has reddish discolouration or streaks.
In the case of PE symptoms include shortness of breath, rapid breathing, chest pain under the ribcage, dizziness and passing out.
Coroner Ho said women should be properly counselled about the increased risk and the symptoms to watch out for by medical professionals before they are prescribed the pill.
He also pointed to death of the second young woman Isabella Rangiamohia Alexander, 17, who collapsed during a walk with her father in the same month.
She was rushed to Auckland Hospital but died shortly after. Blood clots were later found on her legs and lungs.
In the report, Dr Merriman emphasised that, in general, ‘the consequences of unintended pregnancy can present far greater damage to women than safe oral contraception.’
‘The risk of DVT and PE in pregnancy is sixtyfold higher than that from the combined oral contraceptive pill.’