Two Cases of Postpartum Ovarian Vein Thrombosis
2009 Volume 20 Issue 3 Pages 265-269
Details
2009 Volume 20 Issue 3 Pages 265-269
Two cases of postpartum ovarian vein thrombosis (POVT) are reported.
Case 1: A 27-year-old gravida 1, para 1 woman presented with fever and right lower abdominal pain 2 days after vaginal delivery. The leukocyte count was 11700/μl and CRP was 15.0 mg/dl. A diagnosis of endometritis was made and antibiotic therapy was initiated. Three days after initiation of antibiotic therapy, the patient remained febrile and continued abdominal pain. She underwent a contrast-enhanced computed tomography (CECT), which revealed thrombosis of the right ovarian vein.
Case 2: A 29-year-old gravida 1, para 1 woman presented with fever and right lower abdominal pain 8 days after vacuum assisted delivery. The leukocyte count was 8900/μl and CRP was 12.7 mg/dl. A diagnosis of adnexitis was made and antibiotic therapy was initiated. Her symptoms gradually worsened. She underwent a CECT, which revealed thrombosis of the right ovarian vein.
Both of the patients were treated with intravenous heparin and antibiotics. They were discharged uneventfully on warfarin. A high index of suspicion is crucial to diagnose and treat POVT. The diagnosis of POVT can be made accurately with CE-CT. Anticoagulation with heparin is the main stay of treatment for POVT. Additionally, broad-spectrum antibiotics are used for bacterial infection which provoke thrombosis.
