A rare case report of post-partum ovarian vein thrombosis after manual removal of placenta
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20254300Keywords:
Ovarian vein thrombosis, Postpartum, Puerperal, HypercoagulabilityAbstract
Post-partum ovarian vein thrombosis (POVT) is an uncommon diagnosis that may lead to morbidity or mortality if unrecognized. This report discusses a single case of POVT in our hospital, along with the treatment and clinical course. The mechanism is believed to be right-sided clot formation provoked by anatomical and hormonal changes of gestation. Diagnosis is challenging as most patients are previously healthy and symptoms are often vague. Although the differential is broad, modern imaging is sensitive and specific for diagnosis. Prompt treatment with broad-spectrum antibiotics and anticoagulation may reduce morbidity, and prognosis following treatment is excellent.
References
Basili G, Romano N, Bimbi M, Lorenzetti L, Pietrasanta D, Goletti O. Postpartum ovarian vein thrombosis. JSLS. 2011;15(2):268-71.
Harris K, Mehta S, Iskhakov E, Chalhoub M, Maniatis T, Forte F, et al. Ovarian vein thrombosis in the nonpregnant woman: an overlooked diagnosis. Ther Adv Hematol. 2012;3(5):325-8.
Kominiarek MA, Hibbard JU. Postpartum ovarian vein thrombosis: an update. Obstet Gynecol Surv. 2006;61(5):337-42.
Virmani V, Kaza R, Sadaf A, Fasih N, Fraser-Hill M. Imaging of ovarian vein thrombosis. Can Assoc Radiol J. 2012;63(2):109-18.
Bannow BTS, Skeith L. Diagnosis and management of postpartum ovarian vein thrombosis. Hematology Am Soc Hematol Educ Program. 2017;2017(1):168-71.
Lenz CJ, Wysokinski WE, Henkin S, Cohoon KP, Casanegra A, Simmons BS, et al. Ovarian Vein Thrombosis: Incidence of Recurrent Venous Thromboembolism and Survival. Obstet Gynecol. 2017;130(5):1127-35.
Togan T, Turan H, Cifci E, Çiftci C. Ovarian and Renal Vein Thrombosis: A Rare Cause of Fever Outer the Postpartum Period. Case Rep Obstet Gynecol. 2015;2015:817862..
Brown CE, Stettler RW, Twickler D, Cunningham FG. Puerperal septic pelvic thrombophlebitis: incidence and response to heparin therapy. Am J Obstet Gynecol. 1999 Jul;181(1):143-8.
Chan WS, Rey E, Kent NE, VTE in Pregnancy Guideline Working Group, Chan WS, et al. Venous thromboembolism and antithrombotic therapy in pregnancy. J Obstet Gynaecol Can. 2014;36(6):527-53.
Tait C, Baglin T, Watson H, Laffan M, Makris M, Perry D, et al. Guidelines on the investigation and management of venous thrombosis at unusual sites. Br J Haematol. 2012;159(1):28-31.