Ovarian vein and inferior vena cava thrombosis after vaginal delivery: A case report

Abstract

Ovarian vein thrombosis (OVT) is a rare but serious complication, most commonly occurring in the postpartum period. This article reports the case of a 40-year-old woman who presented 12 days after a normal vaginal delivery with fever and pelvic pain. An initial diagnosis of endometritis was made, and empiric antibiotic therapy was administered, but the fever persisted. An ultrasound scan was then done to rule out appendicitis, which revealed a thrombosis of the right ovarian vein extended to the inferior vena cava. Appropriate anticoagulant therapy was immediately started with spectacular clinical improvement. Ovarian vein thrombosis is difficult to diagnose as the signs are nonspecific, like fever and pelvic pain; radiological exploration, typically doppler ultrasound and computerized tomography, are therefore required. Early treatment is crucial to prevent severe complications, especially pulmonary embolism. This case emphasizes the need for heightened clinical awareness and a multidisciplinary approach to achieve optimal outcomes in managing ovarian vein thrombosis.

Keywords: Anticoagulant treatment; Fever; Inferior vena cava; Ovarian vein thrombosis; Postpartum.

Fig. 1

Ultrasound images of right ovarian vein and IVC thrombosis. A: Dilated right ovarian vein measuring 34.2 mm. B: Thrombus along the entire course of the right ovarian vein (white star). C: Thrombus of the IVC measuring 27 mm. D: Hematometra.