Thrombophlebitis of the Right Renal Capsular Vein during the Early Postpartum Period

Venous thrombophlebitis is an uncommon cause of fever and lower abdominal pain during the early postpartum period. It mostly occurs in the right ovarian vein, and computed tomography (CT) is useful for diagnosis. We present a case of thrombophlebitis of the renal capsular vein. A 27-year-old postpartum woman presented with right lower abdominal pain and fever unresponsive to antibiotics. Contrast CT showed a ring-enhancing mass in the right retroperitoneum, which was distinct from the right ovarian vein. Exploratory laparoscopy revealed a retroperitoneal hematoma and normal appendix. Reconstruction of CT images revealed that the mass was connected to the right renal capsular vein. Anticoagulation therapy improved the patient’s symptoms. Postpartum thrombophlebitis can occur at locations other than the ovarian vein, such as the renal capsular vein. If a retroperitoneal mass is discovered during puerperium, a thorough investigation of the mass’s continuity with surrounding vessels is essential to avoid unnecessary surgery.

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Ovarian vein thrombosis in the postnatal period

BMJ Case Reports ◽

10.1136/bcr-2021-243872 ◽

2021 ◽

Vol 14 (6) ◽

pp. e243872

Author(s):

Louise Dunphy ◽

Aie Wei Tang

Keyword(s):

Abdominal Pain ◽

Inferior Vena Cava ◽

Inferior Vena ◽

Elective Caesarean Section ◽

Vena Cava ◽

Lower Abdominal Pain ◽

Ovarian Vein ◽

Vein Thrombosis ◽

The Right ◽

Ovarian Vein Thrombosis

Although ovarian vein thrombosis (OVT) is classically considered a puerperal pathology, it can also occur in nonpuerperal settings such as endometritis, pelvic inflammatory disease, Crohn’s disease, pelvic or gynaecological surgeries and thrombophilia. Hypercoagulation conditions such as antiphospholipid syndrome, systemic lupus erythematosus, factor V Leiden and protein C and S deficiency are all recognised risk factors. It is also a known complication during pregnancy often presenting with fever and lower abdominal pain within weeks after delivery. Its incidence is exceedingly rare, occurring in 0.05% of all pregnancies that result in live births and peaking around 2–6 days after delivery. Its preferential involvement of the right ovarian vein may be explained by the compression of the inferior vena cava and the right ovarian vein due to dextrorotation of the uterus during pregnancy. Furthermore, antegrade flow of blood and multiple incompetent valves in the right ovarian vein favours bacterial infection. Complications may include sepsis and thrombus extension to the inferior vena cava or left renal vein and rarely, pulmonary embolism. The authors present the case of a 27-year-old woman with lower abdominal pain 5 weeks after an elective caesarean section. Although the diagnosis of postpartum endometritis was initially considered, a CT suggested a right OVT. She commenced treatment with low-molecular weight heparin. A high index of clinical suspicion is required in order to establish the diagnosis of this rare cause of abdominal pain, which can mimic an acute abdomen.

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Paracetamol/acetaminophen (single administration) for perineal pain in the early postpartum period

Cochrane Database of Systematic Reviews ◽

10.1002/14651858.cd008407.pub3 ◽

2021 ◽

Author(s):

Edgardo Abalos ◽

Yanina Sguassero ◽

Gillian ML Gyte

Keyword(s):

Postpartum Period ◽

Perineal Pain ◽

Single Administration ◽

Early Postpartum Period ◽

Early Postpartum

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Exclusive Breastfeeding Is Not Associated with Maternal–Infant Bonding in Early Postpartum, Considering Depression, Anxiety, and Parity

Nutrients ◽

10.3390/nu13041184 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1184

Author(s):

Naoki Fukui ◽

Takaharu Motegi ◽

Yuichiro Watanabe ◽

Koyo Hashijiri ◽

Ryusuke Tsuboya ◽

...

Keyword(s):

Mental Health ◽

Path Analysis ◽

Exclusive Breastfeeding ◽

Postpartum Period ◽

Depression Scale ◽

Anxiety And Depression ◽

Women’S Mental Health ◽

Women's Mental Health ◽

Early Postpartum Period ◽

Early Postpartum

It is important to clarify how the breastfeeding method affects women’s mental health, and how women’s mental health affects the breastfeeding method in the early postpartum period when major depression and other psychiatric problems are most likely to occur. This study aimed to examine this bidirectional relationship in the early postpartum period. Participants were 2020 postpartum women who completed the Hospital Anxiety and Depression Scale (HADS) and Mother-to-Infant Bonding Scale (MIBS). We obtained data for participants’ breastfeeding method for four weeks after childbirth. We performed a path analysis with factors including breastfeeding method (exclusive breastfeeding or non-exclusive breastfeeding), parity (primipara or multipara), the two HADS subscales (anxiety and depression), and the two MIBS subscales (lack of affection and anger and rejection). The path analysis showed that breastfeeding method did not significantly affect depression, anxiety, and maternal–infant bonding in the early postpartum period. Women with higher anxiety tended to use both formula-feeding and breastfeeding. Our study suggests that exclusive breastfeeding is not associated with maternal-fetal bonding in early postpartum, considering depression, anxiety, and parity.

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