OVARIAN VEIN-THROMBOSIS DURING CESAREAN-SECTION - A REPORT OF 2 CASES

BACKGROUND: Puerperal ovarian vein thrombosis occurs in 0.2-0.5% of de liveries. If is usually thought to result from infection, but it has b een hypothesized that thrombosis may occur as a primary event, and rad iologic studies mise the possibility that ovarian vein thrombosis may occur quite frequently. CASES: Case I had right ovarian vein thrombosi s diagnosed at the time of nonemergency cesarean section for placenta previa. This was treated with ligation of the infundibulopelvic ligame nt above the level of the clot. Subsequent magnetic resonance imaging showed contralateral ovarian vein thrombosis, and therefore anticoagul ant therapy was begun. The patient was asymptomatic. Case 2 had right ovarian vein thrombosis extending to the inferior venn cava diagnosed at elective repent cesarean section. She was heparinized in the recove ry room; subsequent ventilation/perfusion scan showed a probable pulmo nary embolism. Both patients recovered uneventfully. CONCLUSION: These two cases demonstrate that ovarian vein thrombosis may occur as a pri mary event, in the absence of infection, and result in pulmonary embol ism. Individualized management based on operative findings is recommen ded.