Postpartum ovarian vein thrombosis TOG 2016

Question 1

What proportion of POVT occur in R ovarian vein?

Answer 1

80-90%

Question 2

How does POVT present

Answer 2

Typically with 10 days ON
Vague - abdo pain, pyrexia, nausea, vomiting, malaise, ileus

Fever persists despite Abx

Question 3

Common complication seen?

Answer 3

33% risk PE

Other complications - sepsis, ovarian infarction, extension vein into renal veins/IVC

Question 4

Detection of POVT on USS?

Answer 4

Poor - sensitivity 55%

Question 5

Sensitivity POVT on CT/MRI

Answer 5

CT: 78%
MRI: 100%

Question 6

Management of POVT

Answer 6

Abx and Tx LMWH or warfarin (3-6 months)

Screen for thrombophilia (50% have inherited prothrombbotic RF)