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Thrombolytic complications after childbirth
Last reviewed: 07.07.2025

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Superficial thrombophlebitis
Acute thrombophlebitis is a common complication after childbirth, manifested by pain along the affected vein. Complaints - a local sensation of heat, redness and pain along the subcutaneous vein. The vein is palpated as a dense painful cord, hyperemia can spread beyond the boundaries of the vein compaction, infiltration of adjacent tissues, lymphadenitis are possible. The general condition of the woman in labor is slightly disturbed, subfebrile body temperature, tachycardia are determined.
Deep Vein Thrombophlebitis
Complaints of this complication after childbirth are as follows: patients feel a bursting pain on the affected side, swelling of the affected limb and a change in skin color. Objective manifestations that correspond to the compensation stage: increased body temperature (often the first and only sign of venous thrombosis), no pronounced venous hemodynamic disorders. Objective manifestations that correspond to the decompensation stage: intense pain that often changes its location; a feeling of heaviness and tension; swelling that affects the entire limb, impaired lymph drainage, enlarged regional lymph nodes; a change in skin color from pale to deep cyanotic, diffuse cyanosis of the entire limb predominates.
Diagnosis is based on clinical and laboratory data:
- assessment of the degree of embolism risk - determination of the level of D-dimer in plasma (D-dimer test);
- thromboelastogram, coagulogram;
- determination of the amount of fibrin monomer in blood serum (FM test, monotest-FM);
- Determination of fibrin and fibrinogen degradation products in plasma (FDP PLASMA).
Instrumental methods are used: duplex ultrasound angioscanning with color Doppler mapping; radionuclide study with labeled fibrinogen; radiocontrast retrograde ileocavography.
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Septic thrombophlebitis of the pelvic veins
In endometritis, the infectious agent enters the venous bloodstream, affects the vascular endothelium and promotes thrombus formation, mainly anaerobic infection prevails. The ovarian veins are involved in the process, thrombi can penetrate into the inferior vena cava, renal vein. Complaints - pain in the lower abdomen with irradiation to the back, groin, nausea, vomiting, bloating, fever are possible. During vaginal examination, a thickening in the form of a rope is palpated in the area of the uterine angles. In septic thrombophlebitis, there may be migration of small thrombi into the pulmonary circulation.
Treatment of thrombotic complications after childbirth
Treatment of thrombotic complications in the postpartum period, along with antibiotics and detoxification, should include:
- bed rest with the lower limb placed on a Beler splint until severe edema disappears and the prescription of anticoagulant therapy;
- local hypothermia along the projection of the thrombosed vascular bundle;
- elastic compression using elastic bandages;
- correction of the act of defecation with the use of laxatives (prevention of straining);
- drug therapy;
- anticoagulants during periods of exacerbation of the disease. Direct anticoagulants - heparin, low-molecular heparins (fraxiparin, pentoxan, clexane, fragmin, etc.) with a transition to indirect anticoagulants;
- indirect anticoagulants are prescribed 2 days before the discontinuation of direct anticoagulants for 3-6 months;
- hemorheological active agents - pentoxifylline, rheopolyglucin - followed by a transition to antiplatelet therapy - aspirin, plavix for up to 1 year;
- drugs that improve phlebohemodynamics - phlebodia, detralex, escusan for 4-6 weeks;
- systemic enzyme therapy - wobenzym, phlobenzym, biosin;
- local treatment of complications after childbirth, which is carried out from the first day of the disease:
- local hypothermia;
- use of ointments based on heparin (heparin, troxevasin, lyoton 1000) or non-steroidal anti-inflammatory drugs (fastum gel, diclofenac gel).