Septic pulmonary embolism caused by postpartum ovarian vein thrombophlebitis: A case report.

OBJECTIVE

To report on the clinical considerations for and management of ovarian vein thrombophlebitis (OVT). OVT is an element of septic pelvic thrombophlebitis (SPT). OVT is a relatively uncommon cause of postpartum fever. It manifests in approximately 0.01-0.02% of vaginal deliveries and 0.1% of caesarean births. A delay in diagnosis and treatment can lead to potentially fatal complications.

CASE PRESENTATION

A 38-year-old woman presented to the hospital with a fever and dyspnoea. She had had a spontaneous home birth and developed a low-grade fever after delivery. The infant died 1 h after birth due to an unknown cause. After 72 h of intravenous antibiotic treatment, the patient's condition did not improve. Postpartum endometritis with pneumonia was suspected. OVT was also suspected. The patient received broad-spectrum antibiotics and anticoagulant therapy. After 7 days of treatment, repeat computed tomography scan revealed that the condition of the lungs and uterus had improved.

CONCLUSION

Puerperal fever and septic pulmonary embolism may be signs of OVT. Thus, a diagnosis of OVT should be considered when a patient presents with prolonged fever postpartum and is not responsive to standard endometritis therapy. Moreover, anticoagulant therapy can confirm the diagnosis if the fever subsides following broad-spectrum antibiotic treatment.