Postpartum ovarian vein thrombosis: incidental diagnosis at surgery.

Adebiyi Gbadebo Adesiyun,Modupeola O A Samaila,Austin Ojabo

doi:10.1155/2014/898342

Abstract

Ovarian vein thrombosis is a rare clinical entity that may present in the puerperium. We report the clinical outcomes of two cases of postpartum ovarian vein thrombosis, incidentally diagnosed at laparotomy in 16-year-old and 23-year-old females. They had preoperative diagnosis of torsion tuboovarian mass and twisted pedunculated uterine fibroid, respectively. Both patients had transection and ligation of right thrombosed ovarian vein. Postoperative management included a week course of anticoagulant, antibiotics and analgesia. Postpartum ovarian vein thrombosis is a diagnosis of exclusion in the puerperium and a high index of suspicion will reduce associated morbidity and mortality.

Highlights

Postpartum ovarian vein thrombosis (POVT) is a rare puerperal complication, with an incidence of 1/600 and 1/2000 deliveries [1]
The aim of this paper is to present the clinical outcomes of two cases of postpartum ovarian vein thrombosis diagnosed incidentally at laparatomy
Postpartum ovarian vein thrombosis (POVT) occurs in 0.05% of all pregnancies that results in live births [3] and usually follows vaginal delivery [4]

Summary

Introduction

Postpartum ovarian vein thrombosis (POVT) is a rare puerperal complication, with an incidence of 1/600 and 1/2000 deliveries [1]. Three factors important in the pathogenesis of thrombosis are blood flow stasis, endothelial injury and hypercoagulability states [3]. The postpartum period is known to facilitate the occurrence of blood stasis due to collapse of the ovarian vein that was hitherto three times larger with sixty times increase in blood flow during pregnancy [3]. Endothelial injury is usually triggered by exogenous factors like intrauterine and urinary tract infection [3]. The aim of this paper is to present the clinical outcomes of two cases of postpartum ovarian vein thrombosis diagnosed incidentally at laparatomy

Case 1

Case 2

Findings

Discussion