Die puerperale Ovarialvenenthrombophlebitis (POVT) - eine seltene Wochenbettskomplikation

Puerperal ovarian vein thrombosis (POVT) commonly results from purulent necrotic endomyometritis. The incidence is published to be 1 in 600 deliveries, however, according to own data, the incidence is at least 10 times less frequent. According to the puerperal uterine drainage, the predominant location is the right ovarian vein in 90% of all cases. The leading symptoms are lower abdominal pain localized anteriorly to the psoatic muscle and a tender, barrel shaped unilateral tumor. Discrepancy between the grave clinical picture and the insignificant findings on gyn. examination is common. Ultrasound and computed tomography frequently add in the correct diagnosis. Antibiotic therapy and anticoagulation are recommended in an uneventful course. If clinical improvement is delayed despite non-invasive treatment, surgical intervention with resection of the involved veins and all septic foci becomes mandatory. Despite non-invasive and invasive treatment, pulmonary emboli or septic complication refractory to therapy may contribute to mortality. Therefore POVT should always be included in the differential diagnosis of those patients presenting with a variable fever curve or an unexplained septic course following delivery or miscarriage.