Journal List > Korean J Leg Med > v.39(2) > 1087965

Kim, Kim, Kim, and Ha: Pulmonary Embolism and Uterine Venous Plexus Thrombosis in the Postpartum Period


Pulmonary thromboembolism (PTE) associated with uterine venous plexus thrombosis is very rare. This was recently observed in a puerperal woman without significant medical history. The woman had two pregnancy-associated risk factors for venous thromboembolism, which were obesity and cesarean delivery. A day after cesarean delivery, she presented with dyspnea and cyanosis. When transferred to a larger hospital, no pulse was detected, and she was pronounced dead. Autopsy examination revealed that the cause of death was related to PTE, apparently due to thrombi that originated in the uterine venous plexus.


1. Marik PE, Plante LA. Venous thromboembolic disease and pregnancy. N Engl J Med. 2008; 359:2025–33.
2. Heit JA, Kobbervig CE, James AH, et al. Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study. Ann Intern Med. 2005; 143:697–706.
3. Mavrelos D, Cohen H, Pateman K, et al. Diagnosis of uterine vein thrombosis on transvaginal ultrasound. Ultrasound Obstet Gynecol. 2013; 42:480–3.
4. James AH, Jamison MG, Brancazio LR, et al. Venous thromboembolism during pregnancy and the postpartum period: incidence, risk factors, and mortality. Am J Obstet Gynecol. 2006; 194:1311–5.
5. Larsen TB, Sorensen HT, Gislum M, et al. Maternal smoking, obesity, and risk of venous thromboembolism during pregnancy and the puerperium: a population-based nested case-control study. Thromb Res. 2007; 120:505–9.
6. Fernandes FL, Dinardo CL, Terra-Filho M. Uterine myoma as a cause of iliac vein thrombosis and pulmonary embolism: common disease, rare complication. Respirol Case Rep. 2014; 2:132–4.
7. Leibovitz Z, Degani S, Shapiro I, et al. Diagnosis of pregnancy-associated uterine venous plexus thrombosis on the basis of transvaginal sonography. J Ultrasound Med. 2003; 22:287–93.
8. Al-toma A, Heggelman BG, Kramer MH. Postpartum ovarian vein thrombosis: report of a case and review of literature. Neth J Med. 2003; 61:334–6.
9. Royo P, Alonso-Burgos A, Garcia-Manero M, et al. Postpartum ovarian vein thrombosis after cesarean delivery: a case report. J Med Case Rep. 2008; 2:105.
10. Sammour RN, Gonen R, Ohel G, et al. Cervical varices complicated by thrombosis in pregnancy. Ultrasound Obstet Gynecol. 2011; 37:614–6.

Fig. 1.
A large thrombus was visible in the right pulmonary artery.
Fig. 2.
A thrombus was identified in the uterine venous plexus.
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