Ovarian vein and inferior vena cava thrombosis after vaginal delivery: A case report

Ovarian vein thrombosis (OVT) is a rare but serious complication, most commonly occurring in the postpartum period. This article reports the case of a 40-year-old woman who presented 12 days after a normal vaginal delivery with fever and pelvic pain. An initial diagnosis of endometritis was made, and empiric antibiotic therapy was administered, but the fever persisted. An ultrasound scan was then done to rule out appendicitis, which revealed a thrombosis of the right ovarian vein extended to the inferior vena cava. Appropriate anticoagulant therapy was immediately started with spectacular clinical improvement. Ovarian vein thrombosis is difficult to diagnose as the signs are nonspecific, like fever and pelvic pain; radiological exploration, typically doppler ultrasound and computerized tomography, are therefore required. Early treatment is crucial to prevent severe complications, especially pulmonary embolism. This case emphasizes the need for heightened clinical awareness and a multidisciplinary approach to achieve optimal outcomes in managing ovarian vein thrombosis. •Ovarian vein thrombosis is a rare yet potentially fatal complication of the postpartum period.•It most commonly involves the right ovarian vein, with possible extension into the inferior vena cava.•Diagnosis relies on imaging techniques such as ultrasound and contrast computerized tomography.•Antibiotics and prolonged anticoagulant treatment are essential to prevent complications.s