New observations in postpartum ovarian vein thrombosis: experience of single center

The diagnosis of postpartum ovarian vein thrombosis (POVT) has become more accurate since the introduction of modern imaging techniques. We performed a prospective study at a single Medical Center in order to define the incidence and risk factors for POVT. Thirteen consecutive women with POVT were enrolled during a period of 4 years. Each participant underwent a computerized tomography scan for diagnosis followed by a profile for congenital and acquired thrombophilia. A detailed history of pregnancy, labor and state after delivery was obtained within 2 days of diagnosis while the patient was still hospitalized. The incidence of POVT was four of 30 749 vaginal deliveries, nine of 9604 cesarean deliveries and six of 906 twin deliveries by cesarean section. The odds ratio for developing POVT was 21.37 for twin delivery versus singleton and 7.2 for cesarean section versus vaginal delivery. Of the 13 women with POVT, infection was found in seven women (53%) and other clinical risk factors in four (30%). Only three (23%) participants were found to have thrombophilia and one developed POVT while on enoxaparin treatment. Our results suggest that the risk for maternal POVT is increased by cesarean section delivery of twins. It appears that investigations for thrombophilia are unnecessary when POVT is the sole manifestation of thrombosis.