A case of pregnant with uterine vein thrombosis observed over time by transvaginal ultrasonography

A 42-year-old pregnant woman with gravida 1, primipara, who had undergone in vitro fertilisation. At 31 weeks of gestation, she was admitted to our hospital with lower abdominal pain. Transvaginal ultrasonography (TVU) showed a 70mm sized uterine fibroids on the right side of the lower anterior wall of the uterus. The estimated fetal weight was 2472g (+3.2 standard deviation), but there were no fetal structural abnormalities. Blood test showed a high D-dimer level of 132.5µg/ml, and any thrombosis were suspected. By the computed tomography, a thrombus was found at right uterine vein. When we examined the right uterine vein by TVU, there was a 27mm thrombus with a defect of enhancement by colour Doppler imaging (figure 1). The right uterine vein was wedged between the uterine fibroids and her uterus. Anticoagulant therapy with continuous intravenous infusion of sodium heparin was started. During the treatment, the progress of the thrombus was observed over time by TVU, and the therapeutic effect was confirmed. At 37 weeks of gestation (day 40 of treatment), elective Caesarean section was performed with the indication of breech presentation and there were not any surgical complications. The uterine venous thrombosis might be developed by pregnancy and the position of uterine fibroids in this case. TVU is useful for follow-up of thrombosis over time because it can be performed repeatedly and easily without any complications. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.