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Clinical pearl: An often overlooked cause of postpartum fever : Emergency Medicine News

Figure:

postpartum fever, postpartum ovarian vein thrombosis

BY EMEDHOME.COM

Diagnosis of postpartum ovarian vein thrombosis (POVT) is often delayed because physicians are unaware of the condition, but it should be considered in the differential diagnosis of postpartum fever. (priest. 2022;14[2]:e22504; https://bit.ly/3O8mBqi.)

POVT often presents as fever and lower abdominal pain within one to two weeks of delivery. Most cases occur on the right side, and patients with POVT are often misdiagnosed with appendicitis or a urinary tract infection. (priest. 2022;14[2]:e22504; https://bit.ly/3O8mBqi.) Early detection and intervention are important to prevent pulmonary embolism, a common complication that can lead to death. (priest. 2022;14[2]:e22504; https://bit.ly/3O8mBqi; J Clin Diagn Res. 2016;10[2]:QD03; https://bit.ly/3RDd3qm.)

POVT can be diagnosed by ultrasound and CT with contrast is often recommended, but pelvic MRI appears to have the highest sensitivity and specificity. (Hematology Am Soc Hematol Educ Program. 2017;2017[1]:168; https://bit.ly/3z6aDcm.)

Blood thinners are suggested as standard treatment, and broad-spectrum antibiotics are also frequently used as sepsis is a known complication. (priest. 2022;14[2]:e22504; https://bit.ly/3O8mBqi; J Clin Diagn Res. 2016;10[2]:QD03; https://bit.ly/3RDd3qm; Hematology Am Soc Hematol Educ Program. 2017;2017[1]:168; https://bit.ly/3z6aDcm.)

This clinical pearl first appeared onwww.EMedHome.com, which emails subscribers a new clinical pearl every Wednesday.

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