title: Diagnosis of pregnancy-associated uterine venous plexus thrombosis on the basis of transvaginal sonography.
abstract: OBJECTIVE
  To describe the sonographic signs of uterine venous plexus thrombosis.
  
  
  METHODS
  Four pregnant patients had a diagnosis of uterine venous plexus thrombosis in the first half of gestation. The diagnosis was based on transvaginal sonography only in 3 cases, and the fourth had magnetic resonance imaging corroboration.
  
  
  RESULTS
  All 4 patients had similar sonographic features of uterine venous plexus thrombosis on transvaginal sonographic examination. The thrombi within the dilated veins were shown as elongated echogenic structures along the lumen that appeared round on transverse views of the affected veins. They showed swinging movements provoked by gentle transducer pressure. Power and color Doppler sonography enhanced the uterine venous plexus thrombosis diagnosis by showing blood flow around the thrombi. There were no signs of thromboembolic disease. Sonographic findings in deep leg veins and iliac veins were normal in all cases. Complete thrombophilia studies did not reveal any abnormalities. The uterine venous plexus thrombosis could not be detected on transabdominal sonography and was shown better by transvaginal sonography compared with magnetic resonance imaging. During 3 months of anticoagulation therapy, the thrombi gradually disappeared in all cases.
  
  
  CONCLUSIONS
  Focusing on the pelvic veins while performing a transvaginal sonographic study during pregnancy may reveal important findings, which may have clinical implications. The therapeutic treatment of uterine venous plexus thrombosis is controversial and still empirical.
authors.affiliation: Department of Obstetrics and Gynecology, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Zvi
authors.initials: Z
authors.lastname: Leibovitz
authors.forename: Simon
authors.initials: S
authors.lastname: Degani
authors.forename: Israel
authors.initials: I
authors.lastname: Shapiro
authors.forename: Joseph
authors.initials: J
authors.lastname: Tal
authors.forename: Baram
authors.initials: B
authors.lastname: Paz
authors.forename: Zohar
authors.initials: Z
authors.lastname: Levitan
authors.forename: Ariel
authors.initials: A
authors.lastname: Aharoni
authors.forename: Aurora
authors.initials: A
authors.lastname: Toubi
authors.forename: Lilliana
authors.initials: L
authors.lastname: Schliamser
authors.forename: Elisha
authors.initials: E
authors.lastname: Bar-Meir
authors.forename: Gonen
authors.initials: G
authors.lastname: Ohel
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007001:Hypogastric Plexus / Q000000981:diagnostic imaging / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D014591:Uterine Diseases / Q000150:complications / Q000175:diagnosis*; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology*; D014621:Vagina / Q000000981:diagnostic imaging; D014680:Veins / Q000000981:diagnostic imaging / Q000473:pathology; D020246:Venous Thrombosis / Q000150:complications / Q000175:diagnosis*