Severe Spontaneous Ovarian Hyperstimulation Syndrome With Cervical insufficiency: A Case Report

Abstract

Objectıve: Spontaneous OHSS (sOHSS) is an extremely rare condition in natural conceived pregnancy, it's most often seen in cases of multiple or molar gestations, hypothyroidism and polycystic ovary syndrome. Severe form is a rare entity in singleton pregnancy with spontaneous ovulation and may cause laparotomy because of misdiagnosis such as ovarian tumors or severe complications. We report a rare case of spontaneous severe OHSS. Case report: We report a rare case of spontaneous severe OHSS accompanied by cervical insufficiency at second trimester in singleton pregnancy. The patient was applied at 11 th weeks of gestation with abdominal pain, dyspnea, ascites that was diagnosed OHSS. We managed expectantly without complications. Conclusıon: Although spontaneous OHSS a rare condition, it's important to consider OHSS in cases of bilateral enlarged cystic ovaries in pregnancy. Early diagnosis and successful management is essential to avoid serious complications, which may develop rapidly and may lead significant morbidity and mortality. Figure 1: Wide spread free ascitic fluid in the pelvis and abdominal cavity. Figure 1: Wide spread free ascitic fluid in the pelvis and abdominal cavity.

The implication of single‐nucleotide polymorphisms in ovarian hyperstimulation syndrome

“…No research has, to date, been conducted on a probable impact of SERPINE1 rs1799889 polymorphism on OHSS status. Recently, a case report noticed a patient with spontaneous severe OHSS, demonstrated homozygosity for SERPINE1 4G/5G gene (Demirel, Turhan, Ekmekci, Subasioglu, & Kelekci, ). As far as the distribution of genotypes or alleles is concerned, our observations revealed that there was no significant difference between OHSS patients and patients with normal response to stimulation.…”

A unique variant of spontaneous ovarian hyperstimulation syndrome: case report

“…Spontaneous OHSS tends to present in late first trimester after 8-14 weeks of gestation. 4 Whereas iatrogenic OHSS usually occurs earlier.…”

“…after 8-14 weeks of gestation. 4 We report an unusual case of SOHSS at 4 weeks of gestation with mild enlargement of ovaries, atypical follicles (absence of multiple follicular cysts) in a PCOS woman with singleton gestation, who conceived naturally while taking inositols and metformin prior to conception. To the best of our knowledge this is probably the first case that is being reported and is of clinical significance.…”

Severe ovarian hyperstimulation syndrome with with pleural and pericardial effusion

“…Патофизиология Патофизиологията на ОХС е неизвестна, но процесът е свързан с повишена съдова пропускливост около зоната на яйчниците (4). Хормоните β-hCG, естрадиол, пролактин, хистамин и простагландини отговарят за създаването на ОХС, като е доказано, че вазоактивните вещества като интерлевкини, фактор на тумор некроза (TNF)-α, ендотелин-1 и съдов ендотелен растежен фактор, секретиран от яйчниците, също участват в повишаване на съдовата пропускливост (11,12). Съдовият ендотелен растежен фактор (VEGF) е отговорен за повишаване на съдовата пропускливост и нивата му корелират с тежестта на ОХС (6).…”