Upper body venous thrombosis associated with ovarian stimulation: case report and review of the literature.
Thromboembolic events are a serious complication of assisted conception treatment. Thrombosis may be either arterial or venous but the latter is far more common. This phenomenon is more frequent in the lower limb, but several cases of upper extremity thrombosis have been described in the literature. Although the aetiology of these thromboembolic disorders is not fully understood, the mechanism is thought to be due to a hypercoagulable state associated with haemostasis and thrombophilia. Predisposing factors seem to be hyperoestrogenism, ovarian hyperstimulation syndrome, a hereditary hypercoagulable state and multifoetal pregnancy. We report a case of superior sagittal sinus thrombosis that developed in a patient following successful assisted conception in the absence of evident risk factors. In the current literature, the site of thrombosis, possible predisposing factors, oestrogen levels, number of foetuses, maternal and foetal outcomes, and management of thrombosis were analysed.
Mancuso
A
A
Department of Gynaecological, Obstetrical Sciences and Reproductive Medicine, University of Messina, Italy.
De Vivo
A
A
Fanara
G
G
Di Leo
R
R
Toscano
A
A
D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D004967:Estrogens / Q000097:blood; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000150:complications* / Q000235:genetics; D010062:Ovulation Induction / Q000009:adverse effects; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy / Q000209:etiology*; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011783:Quadruplets; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D020225:Sagittal Sinus Thrombosis / Q000188:drug therapy / Q000209:etiology*; D013480:Superovulation; D019851:Thrombophilia / Q000150:complications / Q000235:genetics
D000925:Anticoagulants; D004967:Estrogens; D006495:Heparin, Low-Molecular-Weight