Spontaneous ovarian hyperstimulation syndrome: A report of two cases from different pathogenesis

Abstract

Spontaneous ovarian hyperstimulation syndrome (s-OHSS) is a rare finding that occurs in early pregnancy. There is a rapidly increasing ovarian size secreting vasoactive substances that lead to fluid shift into third spaces. This occurs in the absence of exogenous hormonal therapy. We present two cases of s-OHSS. A 35-year-old gravida 4 para 3 presented with complaints of progressive abdominal pain, distension, nausea, vomiting, and difficulty in breathing at 10 weeks gestation. On imaging, a singleton intrauterine gestation, enlarged ovaries containing multiple cysts, and moderate ascites were seen. Second, a 17-year-old primigravida presented with abdominal distension and pain and bleeding per vaginam following 4 months amenorrhea. A bulky uterus containing a large hyperechoic structure with multiple cystic spaces in keeping complete molar gestation and enlarged ovaries containing multiple cysts were seen on ultrasound imaging. The singleton gestation was managed successfully to term with conservative therapy tailored to clinical symptoms.

Metastatic choriocarcinoma with hemorrhagic complications and spontaneous ovarian hyperstimulation syndrome: A case report

“…No significant vascularization of solid intracystic components is evident, except for any corpora lutea that usually present an enhanced rim. Ascites, pleural and/or pericardial effusion can be present [39] . Clinical suspicion of OHSS in a patient with diagnosis of choriocarcinoma is difficult due to its rare incidence and overlapping complications deriving from hemorrhagic syndrome.…”

Ovarian Hyperstimulation syndrome combined with hypothyroidism: a comprehensive review

“…The incidence rates of OHSS vary globally. Although OHSS can occur in women with singleton or multiple pregnancies, HT, and pituitary adenomas, with or without pregnancy in very rare cases [7,8], the overall incidence rate of OHSS accounts for approximately 33% of all cycles of in vitro fertilization (IVF) cycles worldwide [9]. In China, the incidence rate of moderate and severe OHSS in women of reproductive age was 1.14% [10].…”