Septic Pelvic Thrombophlebitis: An Unusual Treatable Postpartum Complication

John Keogh, Dermot MacDonald, P. Kelehan
In: Australian and New Zealand Journal of Obstetrics and Gynaecology · 1993 · vol. 33(2) , pp. 204–207 · doi:10.1111/j.1479-828x.1993.tb02395.x · PMID:8216128 · W2094617511
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Abstract

Septic pelvic thrombophlebitis is an uncommon but serious postpartum complication occurring in about 1 in 2,000 pregnancies, characterized by pain, antibiotic resistant fever and tachycardia. In about 50% of cases a pelvic mass is present which is usually right-sided (especially when the ovarian vein is involved). It is estimated to cause 18 maternal deaths per million pregnancies in the United States. Use of contrast enhanced CT scanning and a trial of heparin therapy increases the diagnostic certainty. It is particularly important because surgical management which may otherwise be suggested because of a spiking fever and a mass seems to be associated with a poorer prognosis than does conservative management.

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