SEPTIC PELVIC THROMBOPHLEBITIS - AN UNUSUAL TREATABLE POSTPARTUM COMPLICATION

Septic pelvic thrombophlebitis is an uncommon but serious postpartum c omplication occurring in about 1 in 2,000 pregnancies, characterized b y pain, antibiotic resistant fever and tachycardia. In about 50% of ca ses a pelvic mass is present which is usually right-sided (especially when the ovarian vein is involved). It is estimated to cause 18 matern al deaths per million pregnancies in the United States. Use of contras t enhanced CT scanning and a trial of heparin therapy increases the di agnostic certainty. It is particularly important because surgical mana gement which may otherwise be suggested because of a spiking fever and a mass seems to be associated with a poorer prognosis than does conse rvative management.