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Postpartum Aortic Bifurcation Thrombosis on the Background of Thrombophilic Disorder
Roxana Elena BOHILTEA, Natalia TURCAN, Horia MURESIAN, Silvia CONDU, Elvira BRATILA and Monica Mihaela CIRSTOIU
ABSTRACT
Two main causes of arterial thrombosis are known: first - atherosclerosis, extensively studied, and the second - atrial fibrillation. The lack of any risk factors and the occurrence at young age of a thrombotic event requires us to investigate possible other conditions, including inherited thrombophilia that is represented by a series of genetic disorders that increase the risk of thromboembolic disease. The role of thrombophilia in the occurrence of arterial thrombosis is inconsequential; this disorder is characterized by the tendency of developing venous thrombosis. We present a rare case of a 29 year old woman that presents an arterial thrombotic event subsequent to the caesarean section. The patient had a positive familial history for thrombotic events and a cavernous sinus thrombosis in personal history. Prophylactic treatment with unfractionated heparin throughout pregnancy was applied. At 31 weeks gestation the patient underwent cesarean surgery for nonreassuring fetal status, 2 weeks fetal intrauterine growth restriction and absent diastolic flow of uterine arteries. Three days post operatory arterial thrombosis is suspected. The context that led to this suspicion was paresthesia, color modification of the right leg and abolished popliteal pulse. Angiographic-CT confirmed the presumptive diagnosis. A cardiovascular, conservatory treatment was successfully applied. Considering the particularities of the presented case we discuss the occurrence of arterial thrombosis postpartum in the context of confirmed thrombophilia by reviewing the specialized literature.
Keywords: Thrombophilia, arterial thrombosis, pregnancy