Ovarian hyperstimulation syndrome in a spontaneous singleton pregnancy

Abstract

The ovarian hyperstimulation syndrome is the combination of increased ovarian volume, due to the presence of multiple cysts and vascular hyperpermeability, with subsequent hypovolemia and hemoconcentration. We report a case of spontaneous syndrome in a singleton pregnancy. This was a spontaneous pregnancy with 12 weeks of gestational age. The pregnancy was uneventful until 11 weeks of gestational age. After that, the pregnant woman complained of progressive abdominal distention associated with abdominal discomfort. She did not report other symptoms. In the first trimester, a routine ultrasonography showed enlarged ovaries, multiples cysts and ascites. Upon admission, the patient was hemodynamically stable, her serum β-hCG was 24,487mIU/mL, thyroid-stimulating hormone was 2.2µUI/mL and free T4 was 1.8ng/dL. All results were within normal parameters. However, levels of estradiol were high (10,562pg/mL). During hospitalization, she received albumin, furosemide and prophylactic dose of enoxaparin. The patient was discharged on the sixth hospital day.

Development and management of ovarian hyperstimulation syndrome in spontaneous singleton pregnancy

“…However, vasoactive substances secreted by the ovary, such as TNF-a, endothelin-1, and VEGF, which are better known today, increase vascular permeability. 8,9 According to the De Leener classification, spontaneous OHSS consists of 3 types. Type 1 can cause recurrent OHSS associated with FSH receptor polymorphism.…”

Adnexal Torsion in Ovarian Hyperstimulation Syndrome in Early Pregnancy: A Diagnostic Challenge

“…OHSS is a broad spectrum of signs and symptoms that include abdominal distention and discomfort, enlarged ovary, ascites and other complications of enhanced vascular permeability. 4 Ultrasound is the primary modality. The characteristic findings of "wheel spoke appearance" is seen in OHSS with the peripheral location of follicles and central stroma.…”

Ovarian hyperstimulation syndrome in a spontaneous pregnancy after cessation of a long-term combined oral contraceptive use: A case report

“…In both types of OHSS, hCG is thought to play a key role in the development of OHSS (6). The OHSS is rarely seen in spontaneous cycles (4,5). Spontaneous OHSS usually develops at 8-14 weeks of gestation, while iatrogenic OHSS generally reported to develop between 3 and 8 weeks of gestation.…”

“…The OHSS frequently occurs due to the the administration of hCG in COH cycles (2,3). However, OHSS has been reported rarely in normal spontaneous pregnancy cases (4,5).…”