Pulmonary embolism caused by postpartum ovarian vein thrombophlebitis after vaginal delivery: Case report and brief review of the literature

Fei, Zhengdong; Peng, Aiqin; Wang, Lei; Zhang, Lu

doi:10.1002/jcu.22814

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…Nowadays, non-invasive examinations such as Doppler ultrasound, magnetic resonance imaging (MRI), or enhanced MDCT are the main methods for diagnosing POVT, with a sensitivity of 52%, 92%, and 100%, respectively[ 5 , 6 , 10 - 13 ]. Ultrasound is considered to be the preferred method of obstetric examination due to its flexible and real-time characteristics; however, its accuracy often depends on the operator's experience and operating skills[ 13 , 14 ]. With the development of ultrasound technology and the improvement of the diagnostic level of sonographers, reports of ultrasound diagnosis of POVT have appeared one after another.…”

Section: Discussionmentioning

confidence: 99%

“…In POVT patients, the incidence of pulmonary embolism is about 13.2%, while the mortality rate of POVT is less than 5%, which is mostly caused by pulmonary embolism. A venous filter can usually prevent the pulmonary embolism clinically[ 13 ]. Due to the scarce incidence of POVT, there has been no standard treatment for POVT, and treatment for deep vein thrombosis is often adopted.…”

Section: Discussionmentioning

confidence: 99%

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Computed tomography diagnosed left ovarian venous thrombophlebitis after vaginal delivery: A case report

Wang¹,

Hui²,

Ji³

et al. 2023

World J Clin Cases

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BACKGROUND Postpartum ovarian vein thrombophlebitis (POVT) is a rare but serious postpartum complication that affects mostly postpartum women. A high index of suspicion is required when faced with sudden postpartum abdominal pain. CASE SUMMARY A 25-year-old healthy woman who accepted a vaginal delivery procedure suffered fever (temperature 39.6℃) one day after delivery, accompanied with left lower abdominal pain. Physical examination indicated mild tenderness in the left lower abdomen, accompanied with rebound pain. The patient was confirmed to have left ovarian venous thrombosis with inflammation after receiving a multi-detector row computed tomography scan. CONCLUSION POVT is a rare and dangerous postpartum complication. A high index of suspicion is required for the occurrence of ovarian venous thrombosis when faced with postpartum abdominal pain and fever. Early application of Doppler ultrasound, computed tomography, magnetic resonance imaging and other auxiliary examinations is conducive to timely and accurate diagnosis of POVT, thus reducing maternal mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Computed tomography diagnosed left ovarian venous thrombophlebitis after vaginal delivery: A case report

Wang¹,

Hui²,

Ji³

et al. 2023

World J Clin Cases

View full text Add to dashboard Cite

show abstract

“…As the ovarian veins have a deep anatomical location, positive signs on physical examination are also difficult to detect. Hence, the disease is easily missed and misdiagnosed and can lead to serious and fatal complications such as pulmonary embolism[ 11 , 12 ]. According to the literature[ 13 ], the peak onset of POVT is 2 d after delivery, and about 90% of cases occurred within 10 d of delivery.…”

Section: Discussionmentioning

confidence: 99%

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

Zhu¹,

Shen²,

Wu³

et al. 2023

World J Clin Cases

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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.

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“…With ultrasonography, a tubular, strip-shaped, hypoechoic lesion is visible adjacent to the abdominal aorta or inferior vena cava when OVT is present, extending upward from the lateral side of the left or right ovary. However, ultrasonography has limited value because the ovarian vein is located in the retroperitoneum and intestinal gas can obscure it [ 8 ]. A thick-walled, enlarged ovarian vein with a filling defect will be visible on a CT scan [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Pulmonary embolism caused by postpartum ovarian vein thrombophlebitis after vaginal delivery: Case report and brief review of the literature

Cited by 6 publications

References 6 publications

Computed tomography diagnosed left ovarian venous thrombophlebitis after vaginal delivery: A case report

Computed tomography diagnosed left ovarian venous thrombophlebitis after vaginal delivery: A case report

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

Septic pulmonary embolism caused by postpartum ovarian vein thrombophlebitis: A case report

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