Abstract: Pregnancy and puerperium constitute hyper-thrombotic state, nonetheless venous thrombo-embolic episode is uncommon. We report a case of extensive Deep Vein Thrombosis (DVT), large thrombus in Inferior Vena Cava (IVC) and minimal Pulmonary Embolism (PE) in 24-yr-old primiparous lady who presented with swelling, pain and difficulty in walking since a week, after delivery 33 days ago.
Antenatal period was marked by persistent hypoglycemia and very high serum Insulin levels during third trimester, no cause was detected thereof and both normalized spontaneously after parturition.
Unfractionated Heparin administered, urgent IVC filter deployed followed by LMWH (Low Molecular weight Heparin)and Vitamin-K antagonist NICOUMALONE to obtain PT/INR in therapeutic range.
A week later she got discharged when asymptomatic and swelling in her right leg started reducing.
During review 6weeks later, she remained asymptomatic; non-contrast MRI visualised near complete resolution of thrombus in IVC and pulmonary artery and patent right internal and common iliac veins.
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