Septic pelvic thrombophlebitis information

This article needs additional citations for verification. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. Find sources: "Septic pelvic thrombophlebitis" – news · newspapers · books · scholar · JSTOR (January 2017) (Learn how and when to remove this message)

Septic pelvic thrombophlebitis (SPT), also known as suppurative pelvic thrombophlebitis, is a rare postpartum complication which consists of a persistent postpartum fever that is not responsive to broad-spectrum antibiotics, in which pelvic infection leads to infection of the vein wall and intimal damage leading to thrombogenesis in the ovarian veins (left or right, although right is more common due to dextroversion of the uterus). The thrombus is then invaded by microorganisms. Ascending infections cause 99% of postpartum SPT.

Septic pelvis thrombophlembitis is a cause of post-operative fever from untreated postpartum endometritis or parametritis. After 48 hours of unresolved postpartum endometritis (notably 48 hours of fever that is unaffected by antibiotics), SPT is assumed until proven otherwise (with pelvic radiography). Imaging studies can be helpful in patient refractory to broad-spectrum parenteral antibiotics to look for abscess, retained products, or septic pelvic thrombophlebitis.^[1] Current treatments consist of a combination of antibiotics selected based on suspected pathogen(s), and anticoagulants.

Though the greatest risk factors involve delivery or delivery-related complications, in some rare cases, SPT may arise after abortion procedures^[2] and in non-pregnant people with pelvic infections, pelvic surgeries, uterine fibroids,^[3] or underlying cancer.^[4]

SPT can also be further subcategorized into ovarian vein thrombosis (OVT) or puerperal ovarian vein thrombophlebitis (POVT) and deep septic pelvic thrombosis (DSPT).^[5]