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

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.

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.

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.