Sonographic visualization of ovarian veins during the puerperium: An assessment of efficacy

Objective: The purpose of this study was to determine the ability to visualize ovarian veins by sonography in postpartum patients as well as to assess the frequency of ovarian vein thrombosis in these patients. Study Design: Seventy subjects were recruited from either the postpartum ward or labor and delivery unit after vaginal delivery between November 1, 2000, and March 1, 2001. Patients were excluded if they had a previous or current history of venous thrombosis or recently underwent cesarean delivery. Demographic data were recorded. Transabdominal ultrasonography was performed with gray scale or color Doppler imaging for visualization of the right and left ovarian veins. Either power Doppler or pulsed Doppler imaging with spectral analysis was used for verification of the ovarian veins. Logistic regression was used for univariate analysis. Results: Of the 70 parturients studied, both ovarian veins were visualized in 55 women (78.6%). Of the remaining subjects, either the right (n = 6) or the left (n = 6) ovarian vein could not be visualized. In 3 subjects, neither ovarian vein could be visualized (4.3%). An isolated, asymptomatic right ovarian vein thrombus was identified in one subject (1/55, 1.8%) after bilateral tubal ligation was performed. Maternal age, parity, body mass index, gestational age, spontaneous versus operative vaginal delivery, neonatal sex, or sonographer (radiologist versus perinatologist) did not correlate with ability to visualize the ovarian veins; however, increasing birth weight tended positively toward significance (P = .064). Conclusion: Most ovarian veins can be visualized sonographically during the early puerperium. Additional imaging studies should be considered when a diagnosis is unclear. The presence of an asymptomatic ovarian vein thrombus is unusual and is of uncertain importance. (Am J Obstet Gynecol 2002;186:893-5.)