Early diagnosis and precision treatment of right ovarian vein and inferior vena cava thrombosis following caesarean section: A case report

Abstract

Ovarian vein thrombosis (OVT) is a rare medical complication that is most often diagnosed in the post-partum period. OVT can lead to conditions, including sepsis, inferior vena cava (IVC), pulmonary emboli and mortality. The current study outlines a case of a patient who experienced pain in the lower abdomen and waist without fever postpartum following caesarean section (CS). Plasma FDP, D-Dimer and fibrinogen levels were markedly increased following CS and this was an indicator of the rapid progression of blood coagulation and fibrinolysis. Increased maternal lipid may be one of the risk factors for thrombosis. Based on the clinical presentation, a CT scan demonstrated thrombosis of the right ovarian vein and inferior vena cava, and a diagnosis of OVT and IVC thrombosis was subsequently made. In the current case, an anticoagulant therapy was started with a subcutaneous injection low molecular weight heparin calcium, an intravenous urokinase drip as a thrombolytic agent and implantation of inferior vena cava filters as a novel method of treatment for thrombosis. The patient was discharged from hospital 20 days following treatment in a good condition. The current study reports a case of OVT associated with IVC that was successfully managed without complication.

Can Necrosis and Ovarian Vein Thrombus Be a Serious Complication in Morbidly Adherent Placenta?

“…The process can take place without any symptoms; when symptomatic, abdominal pain and fever are common. [15] [16]. In the present case, the patient had abdominal pain, but signs of necrosis and thrombosis of the pelvic vessels were only observed during the transoperative period.…”

Ovarian vein and IVC thrombosis due to normal vaginal delivery; a case report and literature review

“…C-section increases the risk of ovarian vein thrombosis compared to normal vaginal delivery since the veins dilate and contain a low blood flow throughout pregnancy, specifically during anaesthesia. Higher tissue trauma and bed rest following a C-section could justify the higher prevalence of ovarian vein thrombosis following caesarean section compared to normal vaginal delivery [ 1 ]. In our case, the possibility of the situation being due to atherosclerosis was low given that the patient's test results indicated no issues –for instance, triglycerides and LDL were normal- and there was no history of thrombotic disorders in her, or her family.…”

“…The causes of this complication are divided into two categories of pregnancy-related and non-pregnancy-related causes (infections, pelvic surgeries, malignancies, and coagulation disorders). [ 1 , 2 ]…”

“…The prevalence of the aforementioned, varies across different studies but has been reported to be between 0.05 and 0.2% of total pregnancies and 1–2% of caesarean sections in most cases [ 1 , 2 , 5 ]. The right ovarian vein is more likely to be involved compared to the left ovarian vein (80% vs. 6%) and both veins are involved in 14% of the cases.…”

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

“…This is the case with our patient. The drop in blood flow, the increase in tissue trauma and bed rest after a caesarean section would be responsible for this [16]. Diagnostic Clinical examination can find suggestive signs in 50% of cases.…”