The Natural History of Uterine Venous Plexus Thrombosis

Abstract

The management of incidental or unusual site venous thrombosis (VT) is challenging and is often extrapolated from studies on symptomatic deep venous thrombosis (DVT). There is a tendency to treat with anticoagulation, due to the theoretical risk of propagation and embolism; however, this is not without risk. Furthermore, there is little guidance on how to monitor incidental VT. The aim of this study was to describe the natural history of incidental uterine venous plexus thrombosis (UVPT) and provide a structured approach to its overall management. A prospective study was conducted in a university teaching hospital over a 16-month period. Women diagnosed with UVPT on transvaginal ultrasound (TVS) were followed up over a six-month period and managed based on an individualised risk assessments, in conjunction with haematologists. Fifty women were diagnosed with UVPT during the study period, of which 38 were managed expectantly. The resolution was documented in 70% of women. There were no cases of symptomatic DVT or pulmonary embolisms in either the expectant or treatment groups. Our study has shown that in a high proportion of women, incidental UVPT could be managed successfully without the need for anticoagulation. The overall management of UVPT should be based on individualised clinical risk assessments.

Pelvic Pain in Reproductive Age: US Findings

“…Thrombosis is observed more frequently on the right, proba-bly due to the greater pressure present in the right gonadal vein than on the left, where the pressure would be protected by the retrograde flow of the left renal vein; the right ovary, the ipsilateral iliopsoas muscle, and the inferior vena cava are therefore frequently affected [1,43]. Uterine venous plexus thrombosis is also an unusual site of thrombosis often asymptomatic and incidental detected by TSV-US, which is decisive in the diagnosis and subsequent therapeutic choices [45]. US approach of gonadic vein thrombosis combines TSA-US and TSV-US.…”

Uterine fibroids and the problem of deep vein thrombosis of the lower extremities. View of a vascular specialist and hematologist

“…D-димер сироватки та фібриноген використовуються як параметр коагуляції та змінюються при зміні функції згортання. Високі рівні D-димеру у плазмі свідчать про активність коагуляції та фібринолізу й опосередковані підвищеним ризиком венозної тромбоемболії в пацієнток з ММ [32].…”