Clinical Characteristics and Management of Ovarian Vein Thrombosis: A Case Series

Abstract

BackgroundOvarian vein thrombosis (OVT) is an uncommon condition, occurring in ~1 in every 600–2,000 pregnancies. It is associated with various conditions, including thrombophilia, malignancy, sepsis, intra-abdominal and pelvic inflammatory conditions, pregnancy, and the postpartum period, and specific surgical interventions, particularly gynecological surgeries. Thus, this study aims to identify the associated factors for OVT and elaborate on the standard treatment strategies for its management.MethodsRetrospective data collection was used. Our study consists of 18 patients diagnosed with OVT between 2005 and 2016; the data was collected from the Health Information Management system at King Fahad Medical City, Riyadh, Saudi Arabia using a standard format.ResultsOur study found that OVT involves the right ovarian vein more often than the left and mainly occurs in women during their postpartum period. These patients other associated factor included hypertension, diabetes, and a higher body mass index (BMI) of above 25 kg/m2. The most frequently presenting complaints were abdominal pain and fever. The most common treatment was the administration of enoxaparin (a low molecular weight heparin) for an average duration of one to three months, which resulted in a low recurrence rate of OVT.ConclusionsPhysicians should be vigilant for suspicion of OVT in female patients presenting with lower abdominal pain and fever in their postpartum period. Additionally, it is suggested to use low molecular weight heparin as initial therapy for OVT for one to three months, resulting in a high remission rate.

Ovarian Vein Thrombosis: An Unusual Cause of Abdominal Pain in Breast Cancer

“…In a multicenter study including 74 women with OVT of various etiologies, 89% had acute onset of symptoms, 7% had chronic symptoms, and 4% were asymptomatic [ 8 ]. Alsheef et al published a case series of retrospective data collection of patients diagnosed with OVT over an 11-year period [ 9 ]. The study concluded that the most common presentation was abdominal pain, followed by fever and vomiting.…”

“…It is highly user-dependent and can be limited by body habitus, overlying structures, and bowel gas patterns [ 10 ]. A CT venogram or CT scan of the abdomen and pelvis with contrast is highly sensitive and specific for the diagnosis and is time and cost-effective [ 9 ]. A retrospective study reported that magnetic resonance angiography (MRA) performed better than CT, making it the gold standard for the diagnosis of OVT [ 11 ].…”

Postpartum ovarian vein thrombosis with left renal venous infarction after vaginal delivery

“…Direct oral anticoagulants are discouraged in lactating mothers. It is yet debatable what the optimal duration is for the treatment 7 14. Multiple studies have described that treatment of 3 to 6 months seemed sufficient 9 14 15.…”

Group B Streptococcus infection-induced ovarian vein thrombosis identified during cesarean section: A case report and a literature review

“…[1] Standard treatment for OVT typically involves the use of low molecular weight heparin or warfarin for 1 to 3 months. [2,8]…”

“…[1] Standard treatment for OVT typically involves the use of low molecular weight heparin or warfarin for 1 to 3 months. [2,8] Pregnancy, a physiological state characterized by profound changes in hemostasis, confers an increased susceptibility to venous thromboembolism due to the multifaceted effects of Virchow triad, encompassing hypercoagulability, venous stasis, and endothelial injury. [9] Endothelial injury, a critical component of this triad, can occur during obstetric procedures such as vaginal and cesarean deliveries, and from uterine infections, further exacerbating the prothrombotic milieu associated with pregnancy.…”