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Postpartum infections
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Pelvic thrombophlebitis encompasses two fairly distinct forms—ovarian vein thrombosis and thrombosis of multiple small pelvic vessels. In the acute ovarian vein syndrome, onset is usually within 2 to 4 days postoperatively, but may be weeks after delivery. The patient usually appears ill with a low-grade fever, tachycardia, flank or lower abdominal pain with guarding, and ileus with abdominal distention. Nausea and vomiting may be present. A tender, rope-like, abdominal mass originating near the uterine cornu and extending cephalad and laterally, palpable in one-half to two-thirds of patients, represents the thrombosed ovarian vein. Ovarian vein thrombosis commonly occurs in association with pelvic infection, but the patient’s symptoms worsen, rather than improve, with continued antibiotic therapy. The syndrome may present in the absence of clinical infection, sometimes prompting laparotomy to exclude other disorders. The differential diagnosis includes acute appendicitis, broad ligament hematoma, degenerating fibroid, adnexal torsion, pyelonephritis, ureterolithiasis, and abscess.
Unexplained Fever in Obstetrics
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
Thrombophlebitis and thromboembolic disease occur more frequently in the Puerperium and should be investigated as in the nonpregnant state. Thrombophlebitis in the ovarian veins termed the right ovarian vein syndrome, is characterized by fever and a sausage-shaped tender mass palpated on vaginal examination; anticoagulant therapy is mandatory in such cases.37
Surgical aspects of venous pelvic pain treatment
Published in Current Medical Research and Opinion, 2019
S. G. Gavrilov, O. I. Efremova
The most illustrative are studies comparing the efficacy of various surgical interventions on the gonadal veins. The studies of Scultetus et al., Oliveira et al. and Kirienko et al. have shown that gonadal vein embolization is associated with VPP relief in 80–86% of cases, while resection methods for treating PCS result in elimination of VPP in 92–100% of patients20–22. Hamoodi et al. rightly point out that embolization can often do more harm than good. Other negative consequences of endovascular occlusion of the gonadal veins include migration of coils into the pulmonary arterial bed (up to 4% of cases) and their protrusion through the vessel wall23. The latter complication probably leads to increased pain after the intervention in 4–10% of patients. This treatment method is contraindicated in case of dilation of gonadal veins greater than 8–10 mm, in the presence of right ovarian vein syndrome or patient’s intolerance to contrast media.