Ongoing Twin Pregnancy in an Obese, Polycystic Patient with Early Critical Ovarian Hyperstimulation Syndrome and Severe Liver Dysfunction: Case Report

Sarıkaya, Esma; Deveer, Rüya; Kiliç, Sevtap; Batıoğlu, Sertaç

doi:10.5336/medsci.2009-16399

Cited by 3 publications

(4 citation statements)

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“…In the reported cases, including our case, seven women were able to deliver [ 3 , 27 , 28 , 30 – 34 ], and for five women the pregnancy outcomes were unfavourable [ 3 , 22 , 27 , 30 , 33 ]. Among the women who delivered, three delivered at term [ 31 – 33 ] and one of them developed ICP during the third trimester [ 31 ].…”

Section: Discussionmentioning

confidence: 83%

“…To the best of our knowledge, all reported cases and available data are summarized in Table 1 . Considering only manuscripts reporting ICP in the first trimester after OHSS, we found ten reports published [ 3 , 22 , 27 – 34 ]. Two of the articles reported two cases [ 3 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Including our case, all reported pregnancies obtained with ARTs were complicated by OHSS. Four cases were twin pregnancies [ 3 , 28 , 34 ] and one was a triplet pregnancy [ 29 ]. All cases of first trimester ICP occurred after moderate to critical OHSS and the liver dysfunction appeared between the 6 th and the 9 th week of gestation.…”

Section: Discussionmentioning

confidence: 99%

“…Among the women who delivered, three delivered at term [ 31 – 33 ] and one of them developed ICP during the third trimester [ 31 ]. All the other women delivered prematurely through caesarean section [ 3 , 28 , 34 ]: two of them developed ICP during the third trimester [ 28 ] and one developed hypertension [ 34 ] (Table 1 ). In our case, caesarean section was performed at the 36 th week of gestation because of the increased bile acids levels and pathologic alterations that emerged during CTG monitoring.…”

Section: Discussionmentioning

confidence: 99%

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Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review

et al. 2023

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Background Intrahepatic cholestasis of pregnancy (ICP) in the first trimester occurring after ovarian hyperstimulation syndrome (OHSS) is a rare condition and few cases are reported in the literature. Hyperestrogenism may explain this problem in genetically predisposed women. The objective of this article is to report one of these rare cases and offer an overview of the other published cases. Case presentation We report a case of severe OHSS followed by ICP in the first trimester. The patient was admitted to the intensive care unit and was treated according to the guidelines for the management of OHSS. Moreover, the patient also received ursodeoxycholic acid for ICP, which brought to an improvement of her clinical conditions. The pregnancy continued without other complications until the 36th week of gestation, when the patient developed ICP in the third trimester and underwent cesarean section for increased bile acid levels and cardiotocographic (CTG) pathologic alterations. The newborn was a healthy baby weighing 2500 gr. We also reviewed other case reports published by other authors about this clinical condition. We present what is, to our knowledge, the first case of ICP developed in the first trimester of pregnancy after OHSS in which genetic polymorphisms of ABCB4 (MDR3) have been investigated. Conclusions ICP in the first trimester might be induced by elevated serum estrogen levels after OHSS in genetically predisposed women. In these women, it might be useful to check for genetic polymorphisms to know if they have a predisposition for ICP recurrence in the third trimester of pregnancy.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review

et al. 2023

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Aspirin/contraceptives/infertility therapies

2019

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Morphological changes in the internal organs of mice with a simulated ovarian hyperstimulation syndrome

Айзятулова

2019

Reproductive Endocrinology

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One of the serious complications of in vitro fertilization, threatening the health and life of patients, is ovarian hyperstimulation syndrome. Since the study of the morphology of the internal organs in a woman with this syndrome is complicated, and sometimes impossible, the creation of an experimental model of this pathology using laboratory animals is relevant. Objective of the study is to evaluate the morphofunctional changes in the internal organs of mice with simulated ovarian hyperstimulation syndrome, by stimulating the superovulation of animals ovaries by exogenous gonadotropic hormones in high doses. Materials and methods. The experiment was carried out on females of hybrid mice (СBA×C57BL) weighing 18-20 g. To simulate ovarian hyperstimulation syndrome, 8 animals were intraperitoneally injected with 20 IU of mare serum gonadotropin, after 48 h-7.5 IU of human chorionic gonadotropin. The control group consisted of 8 animals at the estrus stage, which corresponded to spontaneous ovulation. For the histological study, the fragments of animal organs were fixed in 10% neutral formalin, carried out through alcohols of increasing concentration and embedded in paraffin, histological sections were made, which were clarified in xylene and stained with hematoxylin and eosin. Results. Unlike intact mice, the parenchyma of the internal organs of which correspond to the morphological norm, persistent disorders of angiopathogenic and histoarchitectonics, microcirculation disorders that lead to hyperemia, ischemia, transudation and accumulation of fluid in tissues and interstitial lumen, inflammation of organs are develop in the inner organs of mice with simulated ovarian hyperstimulation syndrome. Conclusion. Unlike intact mice the parenchyma of the internal organs of which corresponds to the morphological norm, vital internal organs of mice with modeled ovarian hyperstimulation syndrome are involved in the pathological process. Animal studies indicate the need for preventive measures to reduce the frequency of ovarian hyperstimulation syndrome for women, in particular, prudent prescribing doses of gonadotropic hormones in controlled ovarian stimulation of ovulation, since ovarian hyperstimulation syndrome leads to pathological processes of internal organs, significantly disrupting their function, sometimes irreversibly.

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Ongoing Twin Pregnancy in an Obese, Polycystic Patient with Early Critical Ovarian Hyperstimulation Syndrome and Severe Liver Dysfunction: Case Report

Cited by 3 publications

References 3 publications

Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review

Intrahepatic cholestasis of pregnancy after ovarian hyperstimulation syndrome with wild-type ABCB4 gene: a peculiar case and literature review

Aspirin/contraceptives/infertility therapies

Morphological changes in the internal organs of mice with a simulated ovarian hyperstimulation syndrome

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