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

BACKGROUND Postpartum ovarian vein thrombosis(POVT)is a rare puerperal complication.It is easily missed or misdiagnosed due to its insidious onset and lack of specific clinical symptoms and signs.This paper reports two patients who developed right ovarian vein thrombosis after cesarean section and vaginal delivery,respectively.CASE SUMMARY Case 1 was a 32-year-old female who underwent a cesarean section in labor at 40 wk of gestation due to fetal distress.The patient was persistently febrile after the operation and escalated antibiotic treatment was ineffective.POVT was diagnosed by abdominal computed tomography(CT)and was treated by increasing the dose of low molecular weight heparin(LMWH).Case 2 was a 21-year-old female with a spontaneous vaginal delivery at 39 wk of gestation.The patient developed fever and abdominal pain 3 days after delivery.POVT was promptly identified by abdominal CT,and the condition was quickly controlled after treatment with LMWH and antibiotics.CONCLUSION These two cases occurred after cesarean section and vaginal delivery,respectively.The diagnosis was mainly based on imaging examination due to the unspecific clinical symptoms and signs,the CT scan provided an especially high diagnostic value.Comparing these two cases,escalating antibiotics alone did not provide significant therapeutic benefit,but the early escalation of anticoagulant dosage seemed to shorten the disease course.Therefore,early diagnosis by CT followed by aggressive anticoagulation might have a positive effect on improving the prognosis of the disease.

Ovarian Vein Thrombosis, Critical Diagnosis at Al-Hasahisa Obstetrics & Gynecology Teaching Hospital in Geziera State, Sudan

Ovarian vein thrombosis (OVT) is a rare thrombotic condition commonly attributed to the puerperium. The complications of OVT can be significant, and diagnosis relies on a high clinical index of suspicion. It can occur with lower quadrant pain that may mimic a surgical abdomen, especially in the setting of recent pregnancy, abdominal surgery, inflammatory disease, or malignancy. Diagnosis can be made with confidence using ultrasound, computed tomography, or magnetic resonance imaging. Management of OVT is particularly important in postpartum patients, with anticoagulation therapy being the treatment of choice.

Abdominal Pain and Fever Indicative Postpartum Ovarian Vein Thrombosis: A Case Report

Introduction: OVT is rare, with an incidence of 0.05% to 0.18% and occurring preferentially in postpartum period. Any delay in management may compromise the patient’s vital prognosis. Observation: We report a case of a 34-year-old patient, G2P3, who delivered twins by cesarean section at 39 weeks of amenorrhea. She presented abdominal pain and fever on the 4th day of postpartum. Biological tests showed a biological inflammatory syndrome and a positive blood culture with gram-positive Staphylococcus. After 72 hours of antibiotics with no clinical or biological improvement, a CT scan revealed a 12 mm thrombus in the lumen of the right ovarian vein’s connection to the inferior vena cava. Antibiotic treatment was continued, associated with an anticoagulant. The evolution was been favorable. Conclusion: Rare and serious pathology, the diagnosis is made using medical imaging. The outcome is generally favorable with antibiotic therapy and anticoagulant therapy.

胚胎移植术后卵巢静脉血栓形成1例及文献回顾

收集嘉兴市妇幼保健院诊治的1例卵巢静脉血栓形成(ovarian vein thrombosis,OVT)患者的病例资料,结合相关文献报道进行分析总结,探讨卵巢静脉血栓形成的临床表现、影像学和治疗。

Surgical high ligation of the ovarian vein and preservation of ovarian function for twisted ovarian tumors

Background Appendectomy is the traditional surgica pulmonary embolism, ovarian necrosis, and secondary Methods We performed surgery for adnexal torsion removal of the ovarian tumor. procedure for correcting torsion of the adnexa. Although it prevents nfection, it can have critical adverse effects on the ovarian function. in 12 patients, using high ligation of the ovarian vein, followed by Results Blood flow in the residual ovary gradually returned to normal within 1-3 months, and a dominant follicle could be seen in the residual ovary within 2-6 months post-surgery in all the 12 cases. Menstruation recovered in these three cases within 2-3 months. Postoperative intrauterine pregnancies occurred in two cases, with a corpus luteum graviditatis in the residual ovary in one case, while the other patient underwent labor after 13 months and a normal ovary on the affected side was seen at cesarean section. Conclusions This new surgical technique involving high ligation of the ovarian vein for adnexal torsion allowed successful preservation of the residual ovary and ovarian blood distribution, and can thus be used for the treatment of primary diseases of the ovary. The surgical procedure is simple, safe, and effective, and warrants extensive application inclinical practice.