Ovarian Hyperstimulation Syndrome (original) (raw)
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Spontaneous Ovarian Hyperstimulation Syndrome in Second Pregnancy of a Healthy Pregnant Woman
ACTA MEDICA IRANICA, 2020
pontaneous ovarian hyperstimulation syndrome (OHSS) is an uncommon type of OHSS that is characterized by gastrointestinal symptoms and complications of accommodation of body fluids in third spaces in the absence of medical ovarian stimulations. This syndrome is mostly seen in multiple or molar pregnancies with an underlying medical condition such as hypothyroidism. Treatment of spontaneous OHSS depends on the patient’s clinical condition. Appropriate management will warrant a successful pregnancy. The aim of this report is to introduce a case of spontaneous ovarian hyperstimulation syndrome in second pregnancy of a healthy pregnant woman. The patient was a 8 weeks pregnant female who referred to gynecology and obstetrics clinic because of gradual abdominal distension, abdominal pain and nausea from one month ago. The patient didn't have any history of the specific predisposing factors of OHSS such as thyroid gland dysfunction or multiple pregnancies. Abdominal sonography showed ...
Onset of Spontaneous Ovarian Hyperstimulation Syndrome in the Third Trimester: Case Report
Cureus, 2022
Ovarian hyperstimulation syndrome (OHSS) is a rare and occasionally fatal complication of ovulation induction. However, OHSS has occurred without interventional ovulation induction and in spontaneous ovulatory cycles. In most reported cases, physiological production of human chorionic gonadotropin was high, as in cases of multiple gestation, molar pregnancy, polycystic ovarian syndrome, and hypothyroidism. We report a very rare case of spontaneous OHSS in a healthy 36-year-old woman, gravida 5 para 2 + 2, 35 weeks pregnant, who had become pregnant naturally. According to our research, this is the first report of a case that occurred in the third trimester.
Ovarian Hyperstimulation Syndrome in Spontaneous Pregnancy
Background: Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of supraphysiologic ovarian stimulation but infrequently has been described in spontaneous pregnancy. Aim: To present a case of a woman in spontaneous pregnancy complicated by OHSS. Results: A 32-year-old gravida 1, para 1 with spontaneous conception, was diagnosed with moderate OHSS at the 11th week of gestation and was managed conservatively. The woman delivered vaginally at term a health female infant.
Development and management of ovarian hyperstimulation syndrome in spontaneous singleton pregnancy
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Ovarian hyperstimulation syndrome (OHSS) is one of the most life-threatening complications of ovulation induction. However, rarely, OHSS can develop spontaneously during pregnancy without induction of ovulation. It has been shown in the literature that some diseases such as polycystic ovary syndrome (PCOS), hypothyroidism, and pituitary adenoma may accompany spontaneous OHSS. Spontaneous OHSS should be included in the differential diagnosis in first-trimester pregnancies with nausea, vomiting, and acute abdomen. The focus should be on preventing possible complications and initiating early treatment immediately after diagnosis.
Ovarian Hyperstimulation Syndrome in Natural Conception
Current Trends in diagnosis & Treatment, 2018
Background: Ovarian hyperstimulation syndrome (OHSS) generally results due to exogenous administration of gonadotropins for ovulation induction in females seeking treatment for infertility. OHSS can lead to life-threatening complications, therefore, its early diagnosis and management are very important. Case report: We hereby report a rare case of OHSS in a spontaneously and naturally conceived pregnancy. Our patient is a 28-year old gravida 3 para 2 live 2 female with a period of gestation of 14 weeks, who presented to us with complaints of abdominal pain, mild distension, nausea, vomiting, and mild degree of breathlessness. All the possibilities that would have caused OHSS in a pregnancy were ruled out with adequate investigations. Ultrasound (USG)-guided aspiration of cyst was done and the cytology was negative for malignancy. The patient and her attendants voluntarily demanded termination of pregnancy for the health interest of the mother. Termination of pregnancy was done. The postabortal period was uneventful. The follow-up scan after 4 weeks revealed bilateral ovaries near normal in size, shape, and volume. No ascites was found this time. Conclusion: As after the termination of pregnancy B-human chorionic gonadotropin (HCG) levels dropped down and ovaries were found to be normal in the follow-up scan, our diagnosis goes more in favor of OHSS. Thus, although OHSS is a characteristic outcome of women who underwent some sort of ovarian induction or assisted reproductive technologies, one must be aware of its occurrence in a spontaneous conception too.
Endocrinology: Ovarian hyperstimulation syndrome associated with spontaneous pregnancy
Human Reproduction, 1996
Ovarian stimulation in a patient who suffered from partial (non-classical) 17a-hyroxylase 17,20 lyase deficiency of the adrenal cortex and gonads is described. Diagnosis was based on measurements of high concentrations of steroid metabolites proximal to the enzymatic block (progesterone, 17-hydropregnenolone and 17-hydroprogesterone); with further rise following adrenocorticotrophic hormone (A-CTH) stimulation, and low steroid concentrations distal to the block. Her basal plasma oestradiol values were low and did not rise even during repeated treatment cycles with maximal ovarian stimulation. However, clinical presentation of ovarian hyperstimulation syndrome (OHSS) developed despite very low oestradiol concentrations, thus seriously questioning the role of oestradiol in the pathogenesis of this condition. The poor correlation between clinical presentation of OHSS and plasma oestradiol values, as presented in this case, supports other data which conclude that oestradiol measurements alone are not sufficient to alert the physician to the possible development of OHSS.
2015
Spontaneous OHSS in a term pregnancy is extremely rare. The aim of this study is to present a case of spontaneous ovarian hyperstimulation syndrome (OHSS) in a term pregnancy. A 29-year-old primigravida woman conceived spontaneously and was observed up until 35 weeks of gestation. During this time the patient had a normal pregnancy with normal ovaries. She applied to the current clinic during the 37th week of gestation with complaints of rapid weight gain, abdominal disturbance, and pain. Ultrasound examination showed large bilateral ovaries with multiple follicles and mild ascites. At 39 weeks of gestation, the ovaries were the same as detected previously, and a caesarean section was performed due to fetal macrosomia. A healthy female foetus weighing 4060 gr was delivered. The enlarged bilateral ovaries containing multiple follicles were drilled with electrocautery. The ovaries returned to a near normal state for two weeks after the birth. There are no reported cases of spontaneous...
Spontaneous Ovarian Hyperstimulation Syndrome: Looking Beyond the Ovary
Fertility & Reproduction
We report a case of a 22-year-old single female with spontaneous ovarian hyperstimulation syndrome (s-OHSS) referred for transvaginal aspiration of follicles. Investigations revealed primary hypothyroidism, mild hyperprolactinaemia and unelevated levels of both follicle stimulating hormone (FSH) and estradiol. Supplementation with L-thyroxine lead to euthyroid status and gradual resolution of signs and symptoms of ovarian hyperstimulation syndrome (OHSS) over 4 months.
Ovarian hyperstimulation syndrome (OHSS)-our clinical experience
2015
Introduction: Ovarian hyperstimulation syndrome (OHSS) is a serious complication of the luteal phase/early pregnancy, usually iatrogenic, after ovulation induction or ovarian hyperstimulation in the context of intrauterine insemination and in vitro fertilization (IVF). It is usually a self limiting disorder but may be more severe and persist longer than usual, if pregnancy is successful. Renal and hepatic dysfunction, thrombosis, hydrothorax, cerebral infarct and adult respiratory distress syndrome (ARDS) are the leading causes of morbidity and mortality seen in severe cases. Materials and methods: This is a retrospective study of two years which included women with clinical signs and symptoms suggestive of OHSS. Diagnosis was confirmed by the investigations. Conservative medical management was the main stay of treatment with daily monitoring of the clinical and biochemical parameters. Surgical management like paracentesis, pleuracentesis, diagnostic laparoscopy and therapeutic term...
A Case of Severe Ovarian Hyperstimulation Syndrome
Indian Journal of Clinical Biochemistry, 2013
Ovulation induction has been an important mode of treatment of infertility. Ovarian stimulation may result in a supraphysiologic response leading to an iatrogenic complication known as the ovarian hyperstimulation syndrome (OHSS). This syndrome is potentially a lethal condition, the pathophysiologic hallmark of which is the accumulation of massive extravascular exudate combined with profound intravascular volume depletion and hemoconcentration. We report a case of severe OHSS with very large ovaries in a 35 year old case of embryo transfer. The patient presented to the emergency department with abdominal pain, massive ascites, respiratory distress and amenorrhea. The patient was managed symptomatically with no complications. Although ovarian hyperstimulation is a rare entity, it is important that the physician recognizes this condition. Prompt diagnosis and successful management is likely to avoid serious and rapid development of complications.