Pregnancy and non-pregnancy related ovarian vein thrombosis: Clinical course and outcome.
OBJECTIVE
To collect and summarize demographic, clinical, laboratory and radiologic characteristics, as well as management and follow-up data, of patients diagnosed with ovarian vein thrombosis.


METHODS
A multicenter retrospective review of all patients diagnosed with ovarian vein thrombosis between January 2000 and May 2015 at three university hospitals.


RESULTS
Data of 74 women were analyzed. Mean age was 31±9years. Sixty (81.1%) cases were pregnancy-related. The presence of at least one underlying risk factor (most commonly active infection or surgery) was more common among pregnancy than non-pregnancy related cases (61.7% vs. 14.3%, P=0.002). Anticoagulation therapy was administered in 98.6% of patients and adjunctive antibiotic therapy in 39 (52.7%). At a median follow-up of 40±38months, only one recurrent thrombotic event was observed, and no events of death. Median duration of anticoagulation treatment tended to be longer among patients with non-pregnancy related OVT (6months [3-14] vs. 3months [3-6], P=0.1). Thrombophilic evaluation detected any thrombophilic risk factor in 12 (20%) and 6 (42.9%) women with pregnancy and non-pregnancy related ovarian vein thrombosis, respectively (P=0.09).


CONCLUSIONS
Pregnancy-related ovarian vein thrombosis is characterized by a provoked nature and a high rate of resolution after short term treatment. Treatment of three months duration of anticoagulation following this condition appeared in this study to be safe, with no recurrences encountered during a median follow up of 40months. Thrombophilia seems to have an important role in ovarian vein thrombosis and should be evaluated in non-pregnancy related cases.
Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Amihai
A
Rottenstreich
Internal Medicine D, Hematology Unit, Shaare Zedek Medical Center, Jerusalem, Israel.
Nael
N
Da'as
Braun School of Public Health and Community Medicine, Faculty of Medicine of the Hebrew University and Hadassah, Jerusalem, Israel.
Geffen
G
Kleinstern
Department of Hematology, Coagulation Unit, Beilinson Hospital, Rabin Medical Center, Petah Tikva, Israel and Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Galia
G
Spectre
Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Hagai
H
Amsalem
Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. Electronic address: ykalish@gmail.com.
Yosef
Y
Kalish
D005260:Female; D006801:Humans; D010053:Ovary / Q000473:pathology*; D011247:Pregnancy; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications*; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology* / Q000473:pathology
Anticoagulation; Ovarian vein thrombosis; Post-partum; Pregnancy; Thrombophilia