Key result
LMWH serves as first-line conservative therapy for postpartum ovarian vein thrombosis, but consensus remains lacking.
Why the study?
Postpartum ovarian vein thrombosis is a rare but potentially fatal condition with no consensus regarding management.
May guide initial LMWH use in postpartum ovarian vein thrombosis; leaves open consensus without prospective trials.
Key content Postpartum ovarian vein thrombosis (POVT) is a rare but potentially fatal condition. Symptoms up to 4 weeks postpartum often include vague abdominal pain and pyrexia. A high index of suspicion is required to make the diagnosis. As there is no consensus regarding management, a multidisciplinary approach is advised. Learning objectives Recognise the symptoms and signs of POVT and formulate a differential diagnosis. Recognise the importance of imaging in confirming the diagnosis and involvement of the multidisciplinary team to plan management. Understand that conservative management with low‐molecular‐weight heparin is the first‐line treatment, and understand the situations that may require vena caval filter insertion or surgical intervention. Ethical issues How can we counsel women about risks of conservative and surgical management of this condition when there is no consensus for this management? Should women who have had an ovarian vein thrombosis in a previous pregnancy be counselled toward avoiding future pregnancy?
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Dougan et al. (2016) conducted a review in Postpartum ovarian vein thrombosis (POVT). Low-molecular-weight heparin was evaluated. Conservative management with low-molecular-weight heparin is the first-line treatment for postpartum ovarian vein thrombosis, though consensus on overall management is lacking.
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