Heparin therapy in postcesarean septic pelvic thrombophlebitis

Eleven cases of septic pelvic thrombophlebitis and persistant fever following cesarean section and cesarean hysterectomy are presented. Addition of heparin to the antibiotic regimen of these patients produced a clinical response within 1--5 days, except in two patients who developed septic pulmonary emboli, which finally resolved with continued heparin therapy. An incidental finding was a high incidence of pelvic thrombophlebitis following hypogastric artery ligation. The results justify a trial of heparin therapy, before resorting to exploratory laparotomy, in postpelvic surgery patients who have unexplained fever.