PELVIC THROMBOPHLEBITIS

PELVIC THROMBOPHLEBITIS
•Involves the ovarian, uterine, or hypogastric veins.

•Itusually follows a mild endometritis and occurs later

than femoral thrombophlebitis, often around the 14th
or 15th day of the puerperium.

•Inflammation of the blood vessels in the pelvic area

causes a partial obstruction, which leads to slowed
blood flow and clots in the stagnant blood in the
vessels.
Risk Factors
 Cesarean Delivery
 Bacterial vaginosis
 Manual removal of the plcenta
 Prolonged labor
 Large amount of mecomnium in amniotic
fluid
 Multiple cervical examination
Assessment
Signs and Symptoms
 A woman suddenly becomes extremely ill
 High fever
 Chills
 Abdominal pain
 Weakness
 General malaise
 The infection can be so severe it necroses
the veins and results in a pelvic abscess.

In severe instances, it can become

systemic and results in a lung, kidney, or
heart valve abscess.
Therapeutic Management
 Total bed rest
 Administration of analgesic, antibiotics,
and anticoagulants
 Teach women preventive measures to
reduce the risk of recurrence with future
pregnancies such as:
- wearing nonconstricting clothing on their
lower extremities
- Resting with feet elevated
- Ambulating daily
 Caution a woman to tell her primary care
provider before her next pregnancy of
the difficult she experienced during her
pregnancy, so that extra prophylactic
precautions can be taken to prevent
thrombophlebitis in a future pregnancy.
The disease runs a long course of 6-8
weeks. If an abscess forms it can be
located by sonogram and incised by
laparotomy.
A woman may need surgery to remove the
affected vessel before she attempts to
become pregnant again.
PULMONARY EMBOLUS
PULMONARY EMBOLUS
- Is obstruction of the pulmonary artery by
a blood clot.
- Usually occurs as a complication of
thrombophlebitis when a blood clot
moves from a leg vein to the pulmonary
artery.
Signs and Symptoms
 Sudden, sharp chest pain
 Tachypnea
 Tachycardia
 Orthopnea(inability to breath except in
an upright position)
 Cyanosis (the blood clot is blocking both
blood flow to the lungs and return to the
heart)
Therapeutic Management
 A woman needs oxygen administered
immediately and is at higher risk for
cardiopulmonary arrest
 Her condition is extremely guarded until
the clot can be lysed or adheres to the
pulmonary artery wall and is reabsorbed
 A woman with a pulmonary embolism
commonly is transferred to an intensive
care unit for continuing care