Postpartum ovarian vein thrombosis after cesarean delivery: a case report

A 22-year-old pregnant woman at term presented to hospital with uterine contractions, abdominal pain, nausea and vomiting. After delivery an ovarian vein thrombosis was diagnosed.Low-molecular weight heparin with broad-spectrum antibiotics are the accepted therapy in non-complicated cases of postpartum ovarian vein thrombosis.In this report we describe a case of postpartum ovarian vein thrombosis (POVT), a rare complication of pregnancy and delivery that increases maternal morbidity. The risk factors, physiopathology features, diagnostic approach and therapeutic options are described.Ovarian vein thrombosis is an uncommon complication. Computed tomography (CT) is most useful in making the diagnosis. Heparin and antibiotics are the accepted therapy in non-complicated cases.A 22-year-old woman who was pregnant at term presented to our hospital with uterine contractions, abdominal pain, nausea and vomiting. The hemogram, ionogram, coagulation work-up and urine culture were normal. There was no relevant family history of disease. Past medical history included one abortion three years previously, use of oral contraceptives for several years, no history of deep vein thrombosis (DVT) and no history of hypertension. In the present pregnancy, there had been a first trimester threat of miscarriage. She was immunized for rubella. There were negative serologies for hepatitis B virus (HBV), varicella zoster virus (VZV), human immunodeficiency virus (HIV) and toxoplasma. Rectal and vaginal cultures were negative for hemolytic streptococci.After admission, a non-stressant test was performed. Fetal tachycardia (170 bpm) with a non-reactive pattern was detected. A fetal Doppler sonography revealed a 'brain-sparing' effect with a cerebroplacental ratio of 0.75 (normal > 1) [1]. An urgent cesarean delivery was performed. Neonatal weight at birth was 2,970 g (P50), the Apgar score was 9–10 and fetal gasometry values were normal.During surgery, a large and bilateral varicose uterine ple