Ellis M H, Nun I B, Rathaus V, Werner M, Shenkman L
Meir Hospital, Kfar Saba, Israel.
Fertil Steril. 1998 Jan;69(1):140-2. doi: 10.1016/s0015-0282(97)00459-7.
To describe a case of bilateral internal jugular vein thrombosis complicating ovarian hyperstimulation syndrome (OHSS).
Case report.
Internal medicine ward in a teaching hospital.
A 28-year-old nulliparous woman undergoing IVF.
INTERVENTION(S): Ultrasonographic Doppler of the neck veins was performed because of pain and swelling in the neck, and bilateral jugular vein thromboses were detected. Laboratory evaluation revealed activated protein C resistance caused by factor V Leiden mutation. Low-molecular-weight heparin (enoxaparin) was administered for the remainder of the pregnancy and for 6 weeks after delivery.
Resolution of jugular venous thromboses documented by ultrasonographic Doppler and normal progression of pregnancy.
RESULT(S): The patient delivered healthy twins at term. There were no complications arising from the jugular vein thromboses or the low-molecular-weight heparin treatment.
CONCLUSION(S): Unusually located venous thrombosis should prompt an evaluation for a hypercoagulable state. The high prevalence (4%-7%) of factor V Leiden mutation in most Western populations and the mutation's potential contribution to thrombotic complications in OHSS suggest that screening for this abnormality in women undergoing IVF may be indicated.
