Saint Sophia Hospital, Warsaw, Poland.
Department of Reproductive Health, Centre of Postgraduate Medical Education, Warsaw, Poland.
Ginekol Pol. 2020;91(6):331-333. doi: 10.5603/GP.a2020.0052.
Inferior vena cava syndrome (IVCS) is a heterogenous group of symptoms resulting in obstruction of the main vein inflow . Common reasons are thrombotic changes and tumors. Incidence of inferior vena cava (IVC) anomalies is 0.3% in general population. Iatrogenic IVC lesions caused by catheter insertion play increasing role. Treatment varies depending on the condition.
32-year old patient was diagnosed with IVC stenosis during infertility related preconception evaluation and informed about increased risk in planned pregnancy. Throughout the well progressing pregnancy patient received low molecular weight heparin.
The diagnosis was confirmed intraoperatively during the planned cesarean section. Early postpartum period was normal and patient was discharged with antithrombotic prophylaxis.
Isolated IVC stenosis in pregnancy has not been yet reported in medical literature. Even though IVC anomalies may be associated with other congenital changes, in this case the central venous line treatment in infancy seems to be the most likely cause. Malformations are often accidentally diagnosed because patients are usually asymptomatic. CT and MRI are recommended diagnostic tools. Conservative treatment is recommended for asymptomatic patients, as opposed to surgical treatment for symptomatic. However, due to condition's rarity, there is no evidence based approach management.
下腔静脉综合征（IVCS）是一组导致主静脉流入受阻的症状，常见的原因是血栓形成改变和肿瘤。下腔静脉（IVC）异常的发生率在一般人群中为 0.3%。由导管插入引起的医源性 IVC 损伤的作用越来越大。治疗方法取决于病情。
一名 32 岁的患者在不孕相关的孕前评估中被诊断为 IVC 狭窄，并被告知在计划妊娠中存在更高的风险。在整个进展顺利的妊娠期间，患者接受了低分子肝素治疗。
在计划进行的剖宫产术中术中确诊。产后早期正常，患者出院时接受了抗血栓预防治疗。
孤立性 IVC 狭窄在妊娠中尚未在医学文献中报道。尽管 IVC 异常可能与其他先天性改变有关，但在这种情况下，婴儿期的中心静脉置管治疗似乎是最有可能的原因。畸形通常是偶然诊断出来的，因为患者通常没有症状。推荐使用 CT 和 MRI 作为诊断工具。对于无症状患者推荐保守治疗，而对于有症状的患者则推荐手术治疗。然而，由于该疾病的罕见性，目前还没有基于证据的治疗方法。
