[Thrombosis of ovarian veins in puerperium associated with heparin-induced thrombocytopenia type II].

We report for the first time on a puerperal ovarian vein thrombophlebitis associated with heparin-induced thrombocytopenia type II. Two weeks after cesarean section with subsequent prophylactic application of heparin a thrombosis in the left deep femoral and pelvic veins and in the right ovarian vein occurred. Despite only moderately reduced platelet count a heparin-induced thrombocytopenia type II was diagnosed by heparin-induced platelet activation test. By treatment with plasmin activator lysis the thrombus was diminished. An operative procedure had been prevented. We conclude that also in cases with only moderately reduced platelet count during and after administration of heparin, especially in patients with wide spread and accumulating thrombosis, the presence of a heparin-induced thrombocytopenia should be taken into consideration. In contrast to difficulties in the management of puerperal ovarian vein thrombophlebitis--occurring independently from heparin-induced thrombocytopenia (surgical treatment necessary in most cases)--occurrence of puerperal ovarian vein thrombophlebitis in relation to heparin-induced thrombocytopenia seems to response better to fibrinolysis and anticoagulation.