Mesenteric Vein Thrombosis Following Impregnation Fertilization-embryo Transfer

Overview

Journal World J Gastrointest Surg

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2017 Nov 8

PMID 29109853

Citations 3

Authors

Masaaki Hirata

Hiroko Yano

Tomoe Taji

Yoshiharu Shirakata

Affiliations

Soon will be listed here.

Abstract

Pregnancy is an acquired hypercoagulable state. Most patients with thrombosis that develops during pregnancy present with deep vein leg thrombosis and/or pulmonary embolism, whereas the development of mesenteric vein thrombosis (MVT) in pregnant patients is rare. We report a case of MVT in a 34-year-old woman who had achieved pregnancy fertilization-embryo transfer (IVF-ET). At 7 wk of gestation, the patient was referred to us due to abdominal pain accompanied by vomiting and hematochezia, and she was diagnosed with superior MVT. Following resection of the gangrenous portion of the small intestine, anticoagulation therapy with unfractionated heparin and thrombolysis therapy via a catheter placed in the superior mesenteric artery were performed, and the patient underwent an artificial abortion. Oral estrogen had been administered for hormone replacement as part of the IVF-ET procedure, and additional precipitating factors related to thrombosis were not found. Pregnancy itself, in addition to the administered estrogen, may have caused MVT in this case. We believe that MVT should be included in the differential diagnosis of a pregnant patient who presents with an acute abdomen.

Citing Articles

Acute mesenteric thrombosis in a pregnant woman with Factor V Leiden mutation with a history of in vitro fertilization and embryo transfer: case report and literature review.

Karahan F, Atay A, Dilek F, Tavusbay C, Atahan M Rev Colomb Obstet Ginecol. 2023; 73(4):388-395.

PMID: 36637387 PMC: 9856615. DOI: 10.18597/rcog.3854.

Intestinal necrosis caused by acute mesenteric ischemia associated with pregnancy: A case report and literature review.

Corrales D, Giraldo D Int J Surg Case Rep. 2020; 74:164-167.

PMID: 32862108 PMC: 7475227. DOI: 10.1016/j.ijscr.2020.08.009.

Acute mesenteric venous thrombosis in a pregnant woman at 35 weeks of gestation: a case report and review of the literature.

Guan X, Huang L, Li L BMC Pregnancy Childbirth. 2018; 18(1):487.

PMID: 30537943 PMC: 6290498. DOI: 10.1186/s12884-018-2126-1.

References

Graubard Z, Friedman M . Mesenteric venous thrombosis associated with pregnancy and oral contraception. A case report. S Afr Med J. 1987; 71(7):453. View

Lin H, Lin C, Huang W . Idiopathic superior mesenteric vein thrombosis resulting in small bowel ischemia in a pregnant woman. Case Rep Obstet Gynecol. 2012; 2011:687250. PMC: 3335606. DOI: 10.1155/2011/687250. View

Van Way 3rd C, BROCKMAN S, Rosenfeld L . Spontaneous thrombosis of the mesenteric veins. Ann Surg. 1971; 173(4):561-8. PMC: 1397396. DOI: 10.1097/00000658-197104000-00013. View

Kumar S, Sarr M, Kamath P . Mesenteric venous thrombosis. N Engl J Med. 2002; 345(23):1683-8. DOI: 10.1056/NEJMra010076. View

Al R, Borekci B, Ozturk G, Akcay M, Kadanali S . Acute mesenteric venous thrombosis due to protein S deficiency in a pregnant woman. J Obstet Gynaecol Res. 2009; 35(4):804-7. DOI: 10.1111/j.1447-0756.2008.01003.x. View

Terzhumanov R, Uchikova E, Paskaleva V, Milchev N, Uchikov A . [Mesenteric venous trombosis and pregnancy--a case report and a short review of the problem]. Akush Ginekol (Sofiia). 2005; 44(3):47-9. View

Garcia-Botella A, Asenjo S, de la Morena-Barrio M, Corral J, Bolanos E, Carlin P . First case with antithrombin deficiency, mesenteric vein thrombosis and pregnancy: Multidisciplinary diagnosis and successful management. Thromb Res. 2016; 144:72-5. DOI: 10.1016/j.thromres.2016.05.011. View

Engelhardt T, Kerstein M . Pregnancy and mesenteric venous thrombosis. South Med J. 1989; 82(11):1441-3. DOI: 10.1097/00007611-198911000-00028. View

Abdu R, Zakhour B, Dallis D . Mesenteric venous thrombosis--1911 to 1984. Surgery. 1987; 101(4):383-8. View

10.

Sonmezer M, Aytac R, Demirel L, Kurtay G . Mesenteric vein thrombosis in a pregnant patient heterozygous for the factor V (1691 G --> A) Leiden mutation. Eur J Obstet Gynecol Reprod Biol. 2004; 114(2):234-5. DOI: 10.1016/j.ejogrb.2003.09.014. View

11.

Bates S, Greer I, Middeldorp S, Veenstra D, Prabulos A, Vandvik P . VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012; 141(2 Suppl):e691S-e736S. PMC: 3278054. DOI: 10.1378/chest.11-2300. View

12.

Reiber B, Gorter R, Tenhagen M, Cense H, Demirkiran A . [Mesenteric venous thrombosis during pregnancy; a rare cause of acute ischaemia of the small intestine]. Ned Tijdschr Geneeskd. 2016; 160:A9898. View

13.

Heit J, Kobbervig C, James A, Petterson T, Bailey K, Melton 3rd L . Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study. Ann Intern Med. 2005; 143(10):697-706. DOI: 10.7326/0003-4819-143-10-200511150-00006. View

14.

Battinelli E, Marshall A, Connors J . The role of thrombophilia in pregnancy. Thrombosis. 2014; 2013:516420. PMC: 3880751. DOI: 10.1155/2013/516420. View

15.

Harward T, Green D, Bergan J, Rizzo R, Yao J . Mesenteric venous thrombosis. J Vasc Surg. 1989; 9(2):328-33. View

16.

Foo E, Sim R, Ng B . Case report of acute splenic and superior mesenteric vein thrombosis and its successful medical management. Ann Acad Med Singap. 1996; 25(5):755-8. View