Pregnancy and non-pregnancy related ovarian vein thrombosis: Clinical course and outcome

- OVT is a rare event which requires high clinical index of suspicion due to its vague presentation
- Pregnancy-related OVT is characterized by a provoked nature and a high rate of resolution after short term treatment
- Three months duration of anticoagulation treatment following this condition was safe, with no recurrences during follow up
- Thrombophilia should be evaluated in non-pregnancy related cases

ObjectiveTo collect and summarize demographic, clinical, laboratory and radiologic characteristics, as well as management and follow-up data, of patients diagnosed with ovarian vein thrombosis.MethodsA multicenter retrospective review of all patients diagnosed with ovarian vein thrombosis between January 2000 and May 2015 at three university hospitals.ResultsData of 74 women were analyzed. Mean age was 31 ± 9 years. 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 ± 38 months, 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 (6 months [3-14] vs. 3 months [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).ConclusionPregnancy-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 40 months. Thrombophilia seems to have an important role in ovarian vein thrombosis and should be evaluated in non-pregnancy related cases.