Ovarian vein thrombosis can mimic acute abdominal pain.
HEALTH The joy of bonding with a newborn infant quickly eradicates the pain and concern over potential delivery complications. You count 10 of the tiniest fingers and toes. Though others say it's too soon to tell, you can already see a parental resemblance and marvel at the child's innate desire to cling. With the worst behind you, it's time to pack up and head home to begin assuming the role as a new mommy, perhaps ignoring anticipated abdominal discomfort along the way.
The Four-Week Vigil
For a small number of women, a successful childbirth opens up an opportunity for serious complications. According to Dr. Thomas J. Takach, "The symptoms of ovarian vein thrombosis usually develop within 4 weeks of delivery, most frequently within the first 4 days. Symptoms typically have an abrupt onset and include chills, fever and abdominal discomfort." The incidence of OVT and potential embolism on the postpartum patient been reported to be from 13% to 33%. Of these cases, 4% are believed to be fatal. 
A Cautious Differential
Ovarian vein thrombosis symptoms are somewhat vague and therefore may be mistaken for other conditions with similar features. It is reported than an appendectomy has been futilely performed to remedy pain in lower right abdominal quadrant.  Differentiation from acute appendicitis, endometritis, hydronephrosis, right-sided ureteral obstruction, and pyelonephritis is necessary. Physicians must be alert to the potential for OVT and have the ability to rule out other processes that may produce similar symptoms in order to preempt catastrophic consequences.
Pregnant women can review the symptoms and treatment options with their obstetrics and gynecology physician during prenatal visits. Though the thought of any potential complication is distressing, early diagnosis and proper care minimizes unfavorable outcomes. This should help decrease anxiety and prevent misdiagnosis by keeping OVT symptoms fresh on the minds of everyone involved with follow-up care.
- Ovarian Vein and Caval Thrombosis. Takach T, et al. Tex Heart Inst J. 2005; 32(4): 579–582. nih.gov
- Ovarian vein thrombosis mimicking acute abdomen: a case report and literature review Arkadopoulos N, et al. World Journal of Emergency Surgery 2011, 6:45. wjes.org