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Bed Rest, Elective Surgery, And Oral Contraceptives

ABSTRACT To the Editor.— In the issue of Aug 23, 1971, of The Journal (217:1107, 1971) Goldfinger suggested that any woman who is taking the "pill" and is to be confined to bed rest should stop the medication for the period of immobilization. The reason given is that the combination of pill-induced hypercoagulability plus bed rest may lead to a a clotting event. We agree with Goldfinger's viewpoint, but wish to point out that the pill-induced hypercoagulability, which is reflected in a drop of antithrombin III activity, accelerated thrombin generation, and a speed-up of the kinetics of fibrin formation (Amer J Obstet Gynec109:868, 1971), does not disappear promptly as soon as the contraceptive medication is discontinued. We have shown on many occasions that the oral-contraceptive-induced hypercoagulability requires up to three weeks to disappear. This is in contrast to the initial development of the hypercoagulability which is clearly measurable