CDC Article-US Medical Eligibility Criteria for Contraceptive Use, 2010

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66 MMWR June 18, 2010 TABLE. (Continued) Classifications for barrier methods,* † including condoms, spermicides, and diaphragms/caps Category Condition b. Malabsorptive procedures: decrease absorption of nutrients and calories by shortening the functional length of the small intestine (Rouxen-Y gastric bypass, biliopancreatic diversion) Cardiovascular Disease Multiple risk factors for arterial cardiovascular disease (such as older age, smoking, diabetes, and hypertension) Condom Spermicide Diaphragm/ cap 1 1 1 1 1 1 Clarifications/Evidence/Comments Hypertension a. Adequately controlled hypertension 1 1 1 b. Elevated blood pressure levels (properly taken measurements) i. Systolic 140–159 mm Hg or 1 1 1 diastolic 90–99 mm Hg ii. Systolic ≥160 mm Hg or diastolic ≥100 mm 1 1 1 Hg § c. Vascular disease 1 1 1 History of high blood pressure during pregnancy (where current blood pressure is measurable and normal) 1 1 1 Deep venous thrombosis (DVT)/pulmonary embolism (PE) a. History of DVT/PE, not on anticoagulant therapy i. Higher risk for recurrent DVT/PE (≥1 risk 1 1 1 factors) • History of estrogen-associated DVT/PE • Pregnancy-associated DVT/PE • Idiopathic DVT/PE • Known thrombophilia, including antiphospholipid syndrome • Active cancer (metastatic, on therapy, or within 6 mos after clinical remission), excluding non-melanoma skin cancer • History of recurrent DVT/PE ii. Lower risk for recurrent DVT/PE (no risk 1 1 1 factors) b. Acute DVT/PE 1 1 1 c. DVT/PE and established on anticoagulant therapy for at least 3 mos i. Higher risk for recurrent DVT/PE (≥1 risk 1 1 1 factors) • Known thrombophilia, including antiphospholipid syndrome • Active cancer (metastatic, on therapy, or within 6 mos after clinical remission), excluding non-melanoma skin cancer • History of recurrent DVT/PE ii. Lower risk for recurrent DVT/PE (no risk 1 1 1 factors) d. Family history (first-degree relatives) 1 1 1 e. Major surgery i. With prolonged immobilization 1 1 1 ii. Without prolonged immobilization 1 1 1 f. Minor surgery without immobilization 1 1 1 Known thrombogenic mutations § (e.g., factor V Leiden; prothrombin mutation; protein S, protein C, and antithrombin deficiencies) 1 1 1 Clarification: Routine screening is not appropriate because of the rarity of the conditions and the high cost of screening.
Vol. 59 / RR-4 Recommendations and Reports 67 TABLE. (Continued) Classifications for barrier methods,* † including condoms, spermicides, and diaphragms/caps Category Condition Condom Spermicide Diaphragm/ cap Clarifications/Evidence/Comments Superficial venous thrombosis a. Varicose veins 1 1 1 b. Superficial thrombophlebitis 1 1 1 Current and history of ischemic heart disease § 1 1 1 Stroke § (history of cerebrovascular accident) 1 1 1 Known hyperlipidemias 1 1 1 Clarification: Routine screening is not appropriate because of the rarity of the conditions and the high cost of screening. Valvular heart disease a. Uncomplicated 1 1 1 b. Complicated § (pulmonary hypertension, risk for atrial fibrillation, history of subacute bacterial endocarditis) 1 1 2 Peripartum cardiomyopathy § a. Normal or mildly impaired cardiac function (New York Heart Association Functional Class I or II: patients with no limitation of activities or patients with slight, mild limitation of activity) (1) i.
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CDC Article-US Medical Eligibility Criteria for Contraceptive Use, 2010

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