Vol 91, No 6 (2020)
Research paper
Published online: 2020-06-30

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Successful pregnancy in women with inferior vena cava stenosis — case report and discussion

Marta Janicka1, Dagmara Filipecka-Tyczka2, Aneta Slabuszewska-Jozwiak3, Radoslaw Pietura4, Grzegorz Jakiel5
Pubmed: 32627154
Ginekol Pol 2020;91(6):331-333.

Abstract

Objectives: Inferior vena cava syndrome (IVCS) is a heterogenous group of symptoms resulting in obstruction of the main
vein inflow . Common reasons are thrombotic changes and tumors. Incidence of inferior vena cava (IVC) anomalies is 0.3%
in general population. Iatrogenic IVC lesions caused by catheter insertion play increasing role. Treatment varies depending
on the condition.
Material and methods: 32-year old patient was diagnosed with IVC stenosis during infertility related preconception
evaluation and informed about increased risk in planned pregnancy. Throughout the well progressing pregnancy patient
received low molecular weight heparin.
Results: The diagnosis was confirmed intraoperatively during the planned cesarean section. Early postpartum period was
normal and patient was discharged with antithrombotic prophylaxis.
Conclusions: Isolated IVC stenosis in pregnancy has not been yet reported in medical literature. Even though IVC anomalies
may be associated with other congenital changes, in this case the central venous line treatment in infancy seems to be the
most likely cause. Malformations are often accidentally diagnosed because patients are usually asymptomatic. CT and MRI
are recommended diagnostic tools. Conservative treatment is recommended for asymptomatic patients, as opposed to
surgical treatment for symptomatic. However, due to condition's rarity, there is no evidence based approach management.

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References

  1. Hartley JW, Awrich AE, Wong J, et al. Diagnosis and treatment of the inferior vena cava syndrome in advanced malignant disease. Am J Surg. 1986; 152(1): 70–74.
  2. Spentzouris G, Zandian A, Cesmebasi A, et al. The clinical anatomy of the inferior vena cava: a review of common congenital anomalies and considerations for clinicians. Clin Anat. 2014; 27(8): 1234–1243.
  3. Hashmi ZA, Smaroff GG. Dual inferior vena cava: two inferior vena cava filters. Ann Thorac Surg. 2007; 84(2): 661–663.
  4. Sonin AH, Mazer MJ, Powers TA. Obstruction of the inferior vena cava: a multiple-modality demonstration of causes, manifestations, and collateral pathways. Radiographics. 1992; 12(2): 309–322.
  5. Vaglio A, Maritati F. Idiopathic Retroperitoneal Fibrosis. J Am Soc Nephrol. 2016; 27(7): 1880–1889.
  6. Humphries A, Stone P, Mirjalili SA. The collateral venous system in late pregnancy: A systematic review of the literature. Clin Anat. 2017; 30(8): 1087–1095.
  7. Ramanathan T, Hughes TM, Richardson AJ. Perinatal inferior vena cava thrombosis and absence of the infrarenal inferior vena cava. J Vasc Surg. 2001; 33(5): 1097–1099.
  8. Bass JE, Redwine MD, Kramer LA, et al. Absence of the infrarenal inferior vena cava with preservation of the suprarenal segment as revealed by CT and MR venography. AJR Am J Roentgenol. 1999; 172(6): 1610–1612.
  9. Salgado Ordóñez F, Gavilán Carrasco JC, Bermúdez Recio FJ, et al. Absence of the inferior vena cava causing repeated deep venous thrombosis in an adult--a case report. Angiology. 1998; 49(11): 951–956.
  10. Tofigh AM, Coscas R, Koskas F, et al. Surgical management of deep venous insufficiency caused by congenital absence of the infrarenal inferior vena cava. Vasc Endovascular Surg. 2008; 42(1): 58–61.
  11. Chee YL, Culligan DJ, Watson HG. Inferior vena cava malformation as a risk factor for deep venous thrombosis in the young. Br J Haematol. 2001; 114(4): 878–880.
  12. Jurga-Karwacka A, Karwacki GM, Schoetzau A, et al. A forgotten disease: Pelvic congestion syndrome as a cause of chronic lower abdominal pain. PLoS One. 2019; 14(4): e0213834.
  13. Collot J, Bletard N, Lamproye A. [Membranous occlusion of the inferior vena cava a rare cause of Budd-Chiari syndrome]. Rev Med Liege. 2018; 73(11): 557–561.
  14. Ding PX, Han XW, Liu C. Type II Abernethy Malformation in a Patient with Primary Budd-Chiari Syndrome. Ann Hepatol. 2019; 18(1): 246–249.
  15. Srinivas BC, Dattatreya PV, Srinivasa KH, et al. Inferior vena cava obstruction: long-term results of endovascular management. Indian Heart J. 2012; 64(2): 162–169.
  16. Haddad RA, Saadaldin M, Kumar B, et al. Deep Vein Thrombosis Provoked by Inferior Vena Cava Agenesis. Case Rep Vasc Med. 2015; 2015: 651436.