Pelvic Venous Congestion During Pregnancy Resulting in Positional Neurologic Symptoms
Joann Lohr1, Emily Wright2, Elizabeth Venard3, Deanna Caminiti3.
1Lohr Surgical Specialists, Cincinnati, OH, USA, 2University of Cincinnati College of Medicene, Cincinnati, OH, USA, 3Seven Hills Women’s Health Centers, Cincinnati, OH, USA.
OBJECTIVES: Pelvic venous congestion has been associated with chronic pain syndromes. The symptoms may be neurologic in nature during pregnancy and worsen if associated with a thromboembolic event.
METHODS: We present a case of May-Thurner Syndrome which complicated the pregnancy of a primip. Her symptoms worsened resulting in disabling neurologic symptoms causing her to miss school and being unable to stand.
RESULTS: This 33 year old female was diagnosed at 28 weeks gestation with a left iliofemoral DVT. She was undertreated with lovenox. Her symptoms progressed to the point she was unable to stand. She had disabling neurologic symptoms which were positional in nature. Her symptoms improved significantly with dose adjustment. A temporary IVC filter was placed for delivery and then removed. Her neurologic symptoms have completely resolved.
CONCLUSIONS: Understanding the pelvic venous circulation and possible collateral drainage pathways is critical to caring for these women when they have pelvic venous congestion which may be worsened during pregnancy.
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