Ovarian hyperstimulation syndrome (OHSS) in spontaneous pregnancy

Authors

  • M. khan MBBS, FCPS. Specialist at Dr. Sulaiman Al Habib medical group, Al Qassim hospital, Saudi Arabia
  • F. Maslami MSC.Manager IVF Laboratories, Clinical embryologist at Dr. Sulaiman Al Habib medical group, Al Qassim hospital, Saudi Arabia
  • E. Elhakim MSC, MRCOG, MD, DRH. OBGYN/IVF Consultant at Dr. Sulaiman Al Habib medical group, Al Qassim hospital, Saudi Arabia

Keywords:

Ovarian hyperstimulation syndrome (OHSS), vitro fertilization (IVF), Human chorionic gonadotropin (hCG), Gonadotropins, Ascites, Pleural effusion

Abstract

It has been known that most cases of ovarianhyperstimulation syndrome (OHSS) are almost exclusively associated withcontrolled ovarian stimulation with gonadotrophins or occasionally, clomiphenecitrate. However, OHSS is also infrequently associated with a ontaneousovulatory cycle, usually in the case of multiple gestations, hypothyroidism, orsevere forms of polycystic ovarian syndrome. Severe OHSS associated with aspontaneously conceived prhyperstimulation syndrome (sOHSS) in a woman whoconceived spontaneously with no underlying disease. All associated risk factorswere excluded, such as multiple gestations, hypothyroidism, or polycysticovarian syndrome. Purpose of this case report is to discuss about the conditionwhich can be associated morbidity and even mortality, if remain undiagnosed andif not managed properly. Furthermore, it is interesting to note thatexploratory laparotomy was performed in six cases, because an ovarian cancerwas suspected. Therefore, clinicians must bear the differential diagnosis ofOHSS in mind if a patient presents with gross ascites and other symptoms ofovarian cancer, which also may be signs of OHSS. This  case report emphasis that by taking allpossible differential diagnoses  intoaccount, unnecessary laparotomy may be avoided pregnancy is are with only fewprevious reports.

References

Avecillas, J.F., Falcone, T., Arroliga, A.C., 2004. Ovarian hyperstimulation syndrome. Crit. Care. Clin. 20, 679–95.

Ayhan, A., Tuncer, Z.S., Aksu, A.T., 1996. Ovarian hyperstimulation syndrome associated with spontaneous pregnancy. Hum. Reprod. 11, 1600-1601.

Budev, M.M., Arroliga, A.C., Falcone, T., 2005. Ovarian hyperstimulation syndrome. Crit. Care. Med. 33,301–306

Chow, K.K., Choo, H.T., 1984. Ovarian hyperstimulation syndrome with clomiphene citrate. Case report. Br J Obstet Gynaecol. 91, 1051–1052.

Elchalal, U., Schenker, J.G., 1997. The pathophysiology of ovarian hyperstimulation syndrome – view and ideas. Hum. Reprod,1129-1137. Review.

Garcia-Velasco, J.A,. 2009. How to avoid ovarian hyperstimulation syndrome: A new indication for dopamine agonists. Reprod. Biomed. Online,18,71–75.

Lipitz, S., Grisaru, D., Achiron, R., Ben-Baruch, G., Schiff, E., Mashiach, S., 1996. Spontaneous ovarian hyperstimulation mimicking an ovarian tumour. Hum. Reprod. 11, 720–721.

Ludwig, M., Gembruch, U., Bauer, O., Diedrich, K., 1998. Ovarian hyperstimulation syndrome (OHSS) in a spontaneous pregnancy with fetal and placental triploidy: information about the general pathophysiology of OHSS. Hum Reprod 13,2082-87. Review.

Navot, D., Bergh, P.A., Laufer, N., 1992. Ovarian hyperstimulation syndrome in novel reproductive technologies: Prevention and treatment. Fertil. Steril. 58, 249–61.

Rothmensch, S., Scommegna, A.,1989. Spontaneous ovarian hyperstimulation syndrome associated with hypothyroidism. Am. J. Obslet. Gynecol. 160, 1220-1222.

Smits, G., Olatunbosun, O., Delbaere, A., Pierson, R., Vassart, G., Costagliola, S., 2003. Ovarian hyperstimulation syndrome Due to a mutation in the follicle-stimulating hormone receptor. N. Engl. J. Med. 349,760-766.

Zalel, Y., Katz, Z., Caspi, B., Ben-Hur, H., Dgani, R., Insler, V., 1992. Spontaneous ovarian hyperstimulation syndrome concomitant with spontaneous pregnancy in a woman with polycystic ovary disease. Am. J. Obstet. Gynecol. 167, 122-124.

Published

2013-10-29

How to Cite

khan, M. ., Maslami, F. ., & Elhakim, E. . (2013). Ovarian hyperstimulation syndrome (OHSS) in spontaneous pregnancy. Scientific Journal of Medical Science, 2(10), 204-207. Retrieved from https://sjournals.com/index.php/sjms/article/view/1310

Issue

Section

Case Report