OC12.05: The prevalence of uterine venous plexus thrombosis: a novel entity

The uterine venous plexus (UVP) is an unusual site for deep venous thrombosis (DVT). Our aim was to determine the prevalence of UVP thrombosis (UVPT) and identify associated risk factors. A prospective observational, cross-sectional study was conducted at a large university teaching hospital. Women attending our general gynecology clinic with a wide variety of presenting symptoms were recruited consecutively. All women underwent a transvaginal ultrasound scan (TVS) which involved detailed examination of the UVP. The main criterion for diagnosis of UVPT was the presence of a solid, hyperechoic intraluminal structure causing partial obstruction of venous blood flow on colour Doppler examination. Women diagnosed with UVPT had thrombophilia screening, lower limb venous duplex imaging and specialist hematological review. Logistic regression was used to examine associations between various risk factors and UVPT. A p-value of < 0.05 was considered statistically significant. We screened 1,298 women, 39 of whom had UVPT, giving a prevalence of 3.0% (95% CI, 2.1-4.1%). Multivariate analysis showed significant associations between multiparity (p = 0.008), pre-menopausal status (p = 0.04), recent surgery (p = 0.02), presence of leg varicose veins (p = 0.01) and a family history of venous thromboembolism (p = 0.01) and the development of UVPT. Thrombophilia was detected in 12.8% women diagnosed with UVPT. The presence of adenomyosis approximately doubled the odds of developing UVPT (OR 2.22, p = 0.02), whereas fibroids and adnexal cysts were associated with a lower risk. The prevalence of UVPT in a general gynecology population was 3.0%. Several demographic and clinical factors were found to be associated with UVPT, which could help to identify women at risk of this condition and facilitate its early detection. This would provide a basis to assess the natural history and clinical significance of this novel clinical finding, and the development of an optimal management approach.