Postpartum Ovarian Vein Thrombosis Research Articles

Postpartum ovarian vein thrombosis after cesarean section and vaginal delivery: Two case reports

Postpartum ovarian vein thrombosis after cesarean section and vaginal delivery: Two case reports

Postpartum ovarian vein thrombosis: a case report.

We present a case of a 30-year-old lady, G4P3A0, previously healthy, who presented at 29+3 weeks to the hospital for preterm premature rupture of membrane. The patient had a Cesarean section (C-section), which was complicated with uterine atony and massive bleeding controlled by emergent intrauterine balloon tamponade and uterine artery embolization. The next day, the patient complained of new-onset right lower quadrant abdominal pain, for which she had an abdominal and pelvic computed tomography (CT) scan that showed OVT. Thus, she was started on anticoagulants, and discharged home. OVT is a rare disorder that has been described as occurring mainly during the postpartum period, after pelvic surgery, or in women with gynecological malignancies. Clinical features of OVT include fever, abdominal pain and tenderness, and a palpable abdominal mass. Diagnosis can be obtained using CT, magnetic resonance (MR), or ultrasound (US) Doppler. Treatment includes a combination of anticoagulants and antibiotics. Mortality is low nowadays.

Update on ovarian vein thrombosis

Rare conditions are always challenging due to the difficulty of diagnosis and the fact that there are no guidelines or protocol. As ovarian vein thrombosis (OVT) has an incidence 60 times lower than deep venous thrombosis (DVT), openmindedness and thinking outside the box is necessary. This short article, looks into the pathophysiology of postpartum ovarian vein thrombosis (PVOT), diagnosis, complications and management.

Potential critical risks of pulmonary thromboembolism from an asymptomatic postpartum ovarian vein thrombosis: a case report

BackgroundOvarian vein thrombosis (OVT) may cause maternal mortality by inducing pulmonary thromboembolism (PTE). However, the prevalence, etiology, risk factors, prognosis, and optimal treatments for asymptomatic OVT during and after pregnancies are unclear, which therefore requires a high clinical index of suspicion for certain diagnoses due to its vague presentation. We herein present a case of asymptomatic postpartum OVT that extended toward the inferior vena cava (IVC), resulting in a potential risk of PTE.Case presentationA 30-year-old postpartum woman presented with slight dyspnea after an uneventful vaginal delivery at 40 weeks of gestation. We checked her laboratory data to exclude lethal thrombosis; D-dimer levels were 85.6 μg/mL. We performed computed tomography (CT) to search the presence of PTE and deep vein thrombosis (DVT); although no signs of PTE and DVT in her legs were detected, CT and trans-abdominal ultrasonography (TAUS) revealed a right OVT. Heparin was administered, and D-dimer levels decreased; warfarin at a dose of 2 mg/day was subsequently administered to control anti-coagulopathy. However, D-dimer was re-elevated despite adequate anticoagulation treatment, and extension of the right OVT to the IVC was detected by CT and TAUS. With warfarin administration, CT and TAUS showed the disappearance of right OVT. The patient was discharged from the hospital 17 days after delivery.ConclusionsEven asymptomatic postpartum OVT may lead to PTE. Universal screening guidelines and optimal treatment strategies for asymptomatic OVT in pregnant and postpartum women should be established through future studies.

Postpartum Ovarian Vein Thrombosis: Case Report

Introduction: Postpartum ovarian vein thrombosis (POVT) is an uncommon diagnosis that may lead to morbidity or mortality if unrecognized. Case Report: This report discusses a single case of POVT in a community hospital, along with the treatment and clinical course. Conclusion: 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.

Postpartum Ovarian Vein Thrombosis: Case Report.

IntroductionPostpartum ovarian vein thrombosis (POVT) is an uncommon diagnosis that may lead to morbidity or mortality if unrecognized.Case ReportThis report discusses a single case of POVT in a community hospital, along with the treatment and clinical course.ConclusionThe 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.

Postpartum ovarian vein thrombosis manifesting as acute appendicitis: a case report

BackgroundPostpartum ovarian thrombosis is an uncommon condition. It appears with the nonspecific, predominantly right-sided abdominal symptoms and must be differentiated from other acute visceral conditions. If left untreated, postpartum ovarian thrombosis can have severe consequences, including sepsis, pulmonary embolism, and even death. Momentarily, there are no specific guidelines for postpartum ovarian thrombosis management. We present a case of postpartum ovarian thrombosis admitted to our hospital with symptoms of acute appendicitis.Case presentation A 39-year-old Omani obese multiparous woman of Afro-Arab origin was admitted with acute symptoms, mainly abdominal pain, fever, and vomiting 1 week postpartum. Clinical picture and biochemical profile did not exhibit a recognizable pattern. Ultrasonography excluded retained products of conception. Computerized scan for abdomen and pelvis with oral and intravenous contrast reported a dilated tubular structure in the right adnexa extending up to the right renal hilum level with surrounding inflammation. Those findings were consistent with the thrombophlebitis of the right ovarian vein. Blood cultures and sensitivity showed group A β-hemolytic streptococci sensitive to penicillin G and clindamycin. The patient was treated successfully with antibiotics and therapeutic anticoagulants and discharged home 3 days later; follow-up was arranged.ConclusionThis pathology is an exceptional entity in Oman. Therefore, awareness of this unique condition is required so that clinicians will be vigilant, exploring similar cases with imaging and avoiding unnecessary surgical interventions.

Postpartum ovarian vein thrombosis after coronavirus disease

Corona virus outbreak started in December 2019, and the disease has been defned by the World Health Organization as a public health emergency. Coronavirus is a source of deep venous thrombosis (DVT) due to complications such as over coagulation, blood stasis, and endothelial damage. In this study, we report a 26-year-old pregnant woman with coronavirus who was hospitalized with a right ovarian vein thrombosis at Sultangazi- Haseki Training and Research Hospital in Istanbul. Risk classifcation for deep vein thrombosis (DVT) disease is of crucial importance for the forecast of coronavirus.

Postpartum septic pelvic thrombophlebitis and ovarian vein thrombosis after caesarean section: a rare case report

BackgroundSeptic pelvic thrombophlebitis (SPT) is a well-recognized but rare puerperal complication that has two types: ovarian vein thrombophlebitis (OVT) and deep septic pelvic thrombophlebitis (DSPT). The present case report describes the clinical and imaging findings of a female patient diagnosed with right ovarian vein infectious thrombophlebitis after caesarean section (C-section).Case presentationA 35-year-old G3P2 female who presented with a foetal vein Galen malformation at 41 weeks of gestation underwent C-section. The patient had high fever after C-section, and anti-inflammatory treatment was not effective within 1 week. An abdominal wall incision haematoma was found, and a second surgery for the removal of the abdominal wall haematoma was performed. The patient was ultimately diagnosed with abdominal incision haematoma and right ovarian vein infectious thrombophlebitis after C-section. We used imipenem and tigecycline to strengthen the anti-inflammatory effects, simultaneously administrating low-molecular-weight heparin and warfarin as anticoagulant therapy. On the 30th day after C-section, the right ovarian vein thrombus disappeared.ConclusionThis case illustrates the need to consider the potential relationship between abdominal incision haematoma and ovarian vein thrombophlebitis. Despite advances in the management of venous thromboembolism globally, more data on epidemiology in terms of first incidence, prevalence, recurrence and risk factors, management of bleeding complications, and increased awareness in Asian populations are necessary.

A rare case of postpartum ovarian vein thrombosis

A rare case of postpartum ovarian vein thrombosis

Renal obstruction caused by postpartum ovarian vein thrombosis.

Renal obstruction caused by postpartum ovarian vein thrombosis.

Management of the postpartum ovarian and partial cava inferior vein thrombosis

Management of the postpartum ovarian and partial cava inferior vein thrombosis

Postpartum Ovarian Vein Thrombosis Associated with Lower Urinary Tract Infection and Vaginitis

Postpartum Ovarian Vein Thrombosis Associated with Lower Urinary Tract Infection and Vaginitis

Postpartum ovarian vein thrombosis – unusual clinical presentation

Postpartum ovarian vein thrombosis is a rare but serious condition. The clinical symptoms are not specific, as a result of which misdiagnosis, leading to delayed management, is unfortunately common. Therefore, the diagnosis should always be considered in patients presenting with acute abdominal pain and fever during the postpartum period. It can be diagnosed by non-invasive radiological modalities, following which early therapy with anticoagulants and broad-spectrum antibiotics can be instituted. We present the case of a 33-year-old woman presenting to an emergency department 2 days post partum with fever and acute pain in the right lower abdominal quadrant. The patient was initially diagnosed as having endometritis and managed accordingly, however, as her condition did not improve, a more serious pathology was suspected. The appropriate radiological procedures corrected the diagnosis and treatment was initiated accordingly.

Post-partum ovarian vein thrombosis

Post-partum ovarian vein thrombosis

Prise en charge de la thrombose veineuse ovarienne du post-partum. L’expérience du CHU d’Amiens

ObjectivesPostpartum ovarian vein thrombophlebitis is an uncommon complication that may threaten mothers’ lives. The extension of thrombosis in the inferior vena cava causes a pulmonary embolisme risk and requires urgent care. The main objective of this study was, from a series of patients, to determine the clinical and paraclincal signs to suggest the diagnosis of postpartum ovarian vein thrombosis. Secondary objectives were to assess the location and extent of thrombosis and the therapeutic management of this disease at the University Hospital of Amiens. MethodsA retrospective study was performed in the Obstetrics and Gynecology department of Amiens University Hospital between January 2011 and May 2015. Were included in this study all patients for whom the diagnosis of postpartum ovarian thrombophlebitis was confirmed by computed tomography. ResultsThirteen patients had postpartum thrombosis of the ovarian vein. The incidence of this disease in our series was 0.13%. The average age of patients was 30years. The median onset of symptoms was located on the 4th day; in 92% of cases, they appeared within 10days after delivery. The clinical picture was not specific and the main symptoms were fever (46.1%) and abdominal pain (53.8%). Biologically inflammatory syndrome was commonly found with elevated leukocytes and CRP. Bacteriological samples were in most cases negative. Sixty-nine percent of lesions concerned the right ovarian vein; 23% had renal extension, 53.8% had inferior vena cava extension and 23% got complicated with pulmonary embolism. No maternal deaths were reported. One hundred percent of patients received anticoagulation at curative dose, the mean duration of which was 6months. In all, 84.6% of patients received in combination antibiotic therapy with oral and parenteral initially broad spectrum. ConclusionOvarian postpartum thrombosis is a rare complication that must be evoked and sought, especially in front of a non-septic febrile abdominal pain syndrome in postpartum.

Post partum ovarian vein thrombosis presenting with left loin pain – A case report

Postpartum ovarian vein thrombosis (POVT) is an uncommon but serious complication. Clinically it is a difficultly diagnosed entity, must be thought of as differential diagnosis in cases of postpartum acute abdomen. POVT may cause serious complications like sepsis, pulmonary embolism, thrombosis of the inferior vena cava and renal veins, and may cause death. It is often clinically indistinguishable from other causes of post partum acute pain. Most of the cases present as right loin and right iliac fossa pain, within initial 10 days of the puerperal period. This report presents a case of left ovarian vein thrombosis complicated by renal vein thrombosis presenting as left ureteric colic. The imaging findings illustrate the difficulty in clinical and radiological diagnosis of post-partum ovarian vein thrombosis, and thus highlight the need to include it as one of the differential diagnosis in such cases of post partum acute abdomen. Anti-coagulants and intravenous antibiotics remain the mainstay of treatment. Non-invasive investigations help in accurate diagnosis of POVT and a surgery can be avoided.

Post-partum ovarian vein thrombosis: combined effect of infection and factor v leiden mutation.

Post-partum ovarian vein thrombosis: combined effect of infection and factor v leiden mutation.

Ovarian vein thrombosis after debulking surgery for ovarian cancer: epidemiology and clinical significance

Ovarian vein thrombosis is associated with pregnancy and pelvic surgery. Postpartum ovarian vein thrombosis is associated with infection and a high morbidity rate and is treated with anticoagulant and intravenous antibiotic therapy. The natural history of such thrombotic events after debulking surgery for ovarian cancer has not been well described. Our objective was to characterize the presentation and outcomes for patients with this condition at our institution. We conducted a retrospective study of patients who underwent surgical debulking for ovarian cancer at Memorial Sloan Kettering Cancer Center between the years 2001 and 2010. Patients were included if contrast computed tomography scans of both the abdomen and pelvis were performed within 12 weeks before and 12 weeks after the surgery. The images were reviewed to assess for the presence and extent of a new postoperative ovarian vein thrombosis. When available, subsequent studies were assessed for thrombus progression. Medical records were reviewed to determine whether anticoagulation was used for treatment of the thrombotic episode and to record the occurrence of any new significant venous thromboembolic event in the next year. One hundred fifty-nine patients had satisfactory imaging. New ovarian vein thrombosis was a common complication of debulking surgery, as found in 41 of patients (25.8%). Only 5 women with ovarian vein thrombosis were started on anticoagulation, of which 2 individuals had an independent venous thromboembolic event as indication for treatment. Only 2 of the ovarian vein thromboses (4.9%) progressed to the inferior vena cava or left renal vein on subsequent scan. The estimated cumulative incidence of venous thromboembolism 1 year after the first postoperative scan was 17.1% for patients in the new ovarian vein thrombosis group vs 15.3% of individuals for the group without a postoperative ovarian vein thrombosis (P = .78). Ovarian vein thrombosis is commonly encountered after debulking surgery for ovarian cancer. Anticoagulation is usually not indicated, and clinically meaningful thrombus progression rarely occurs.

Postpartum ovarian vein thrombosis: incidental diagnosis at surgery.

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.