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Infections in Pregnancy: Septic Pelvic Vein Thrombophlebitis

What Is Septic Pelvic Vein Thrombophlebitis?

The idea of something going wrong during your pregnancy can be extremely worrisome. Most problems are rare, but it’s good to be informed of any risks. Being informed will help you take action as soon as symptoms arise. Septic pelvic vein thrombophlebitis is an extremely rare condition. It occurs after delivery when an infected blood clot, or thrombus, causes inflammation in the pelvic vein, or phlebitis.

Only one in every 3,000 women will develop septic pelvic vein thrombophlebitis after delivery of their baby. The condition is much more common in women who delivered their baby by cesarean delivery, or C-section. Septic pelvic vein thrombophlebitis can be fatal if not treated right away. However, with prompt treatment, most women make a full recovery.

What Are the Symptoms?

Symptoms

Symptoms typically occur within a week after giving birth. The most common symptoms include:

  • fever
  • chills
  • abdominal pain or tenderness
  • flank or back pain
  • a “ropelike” mass in the abdomen
  • nausea
  • vomiting

The fever will persist even after taking antibiotics.

What Causes Septic Pelvic Vein Thrombophlebitis

Causes

Septic pelvic vein thrombophlebitis is caused by a bacterial infection in the blood. It can occur after:

  • vaginal or cesarean delivery
  • miscarriage or abortion
  • gynecological diseases
  • pelvic surgery

The body naturally produces more clotting proteins during pregnancy. This ensures that the blood forms clots quickly after delivery to avoid excess bleeding. These natural changes are meant to protect you from complications during your pregnancy. But they also increase your risk of having a blood clot. Any medical procedure, including delivery of a baby, also carries a risk of infection.

Septic pelvic vein thrombophlebitis is caused when a blood clot forms in the pelvic veins and becomes infected by bacteria present in the uterus.

What Are the Risk factors?

Risk Factors

The incidence of septic pelvic vein thrombophlebitis has declined over the years. It’s now extremely rare. Though it can occur after gynecological surgeries, abortions, or miscarriages, it’s most commonly associated with childbirth.

Certain conditions can increase your risk of septic pelvic vein thrombophlebitis. These include:

  • cesarean delivery
  • pelvic infection, such as endometritis or pelvic inflammatory disease
  • induced abortion
  • pelvic surgery
  • uterine fibroids

Your uterus is more susceptible to infection once the membranes are ruptured during delivery. If bacteria that are normally present in the vagina enter the uterus, the incision from a cesarean delivery may result in endometritis, or infection of the uterus. Endometritis can then lead to septic pelvic vein thrombophlebitis if a blood clot becomes infected.

Blood clots are more likely to form after a cesarean delivery if:

  • you are obese
  • you have complications with surgery
  • you are immobile or on bed rest for a long time after the operation

Diagnosing Septic Pelvic Vein Thrombophlebitis

Diagnosis

Diagnosis can be a challenge. There are no specific laboratory tests available to test for the condition. Symptoms are often similar to many other illnesses. Your doctor will conduct a physical exam and a pelvic exam. They’ll look at your abdomen and uterus for signs of tenderness and discharge. They will ask about your symptoms and how long they have persisted. If your doctor suspects that you have septic pelvic vein thrombophlebitis, they will want to first rule out other possibilities.

Other conditions that could cause similar symptoms include:

  • kidney or urinary tract infection
  • appendicitis
  • hematomas
  • side effects of another medication

You may undergo a CT scan or MRI scan to help your doctor visualize the major pelvic vessels and look for blood clots. However, these types of imaging aren’t always useful to see clots in smaller veins.

Once other conditions are ruled out, the ultimate diagnosis of septic pelvic vein thrombophlebitis may depend on how you respond to treatment.

Treating Septic Pelvic Vein Thrombophlebitis

Treatment

In the past, treatment would involve tying or cutting out the vein. This is no longer the case.

Today, treatment usually involves broad-spectrum antibiotic therapy, such as clindamycin, penicillin, and gentamicin. You may also be given a blood thinner, such as heparin, intravenously. Your condition will most likely improve within a few days. Your doctor will keep you on medication for a week or longer to make sure the infection and the blood clot are both gone.

Be sure to follow your doctor’s instructions during this time. Blood thinners carry a risk of bleeding. Your doctor will need to monitor your treatment to make sure you’re getting just enough blood thinner to prevent blood clots, but not enough to make you bleed too much.

Surgery may be necessary if you don’t respond to the medications.

What Are the Complications of Septic Pelvic Vein Thrombophlebitis?

Complications

The complications of septic pelvic vein thrombophlebitis can be very serious. They include abscesses, or collections of pus, in the pelvis. There’s also a risk of the blood clot traveling to another part of your body. Septic pulmonary embolism occurs when an infected blood clot travels to the lungs.

A pulmonary embolism occurs when a blood clot blocks an artery in your lungs. This can block oxygen from getting to the rest of your body. This is a medical emergency and can be fatal.

Symptoms of a pulmonary embolism include:

  • difficulty breathing
  • chest pain
  • shortness of breath
  • accelerated breathing
  • coughing up blood
  • rapid heart rate

You should seek medical treatment right away if you have any of the above symptoms.

What Is the Outlook for Someone with Septic Pelvic Vein Thrombophlebitis?

Outlook

Advances in medical diagnosis and treatments have greatly improved the outlook for septic pelvic vein thrombophlebitis. Mortality was roughly 50 percent in the early part of the twentieth century. Death from the condition dropped to less than 5 percent during the 1980s and is extremely rare today.

According to one study, advancements in treatments like antibiotics and decreased bed rest after surgery have lowered the rates of diagnosis of septic pelvic vein thrombophlebitis.

Can Septic Pelvic Vein Thrombophlebitis Be Prevented?

Prevention

Septic pelvic vein thrombophlebitis can’t always be prevented. The following precautions might lower your risk:

  • Make sure your doctor uses sterilized equipment during delivery and any surgeries.
  • Take antibiotics as a preventive measure before and after any surgeries, including a cesarean delivery.
  • Make sure to stretch your legs and move around after your cesarean delivery.

Trust your instincts and call your doctor if you feel like something’s wrong. If you ignore the warning signs, it may lead to more serious problems. Many pregnancy problems are treatable if caught early. 

Read This Next

Infections in Pregnancy
Infections in Pregnancy: Yeast Infection
Infections in Pregnancy: Hepatitis
Strep Throat While Pregnant: Symptoms and Treatment
Sinus Infection While Pregnant: Prevent and Treat
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