Severe ovarian hyperstimulation syndrome coexisting with a bilateral ectopic pregnancy.
نویسندگان
چکیده
Management of severe ovarian hyperstimulation syndrome (OHSS) includes hospitalization for fluid and electrolyte management. Abdominal paracentesis is also used as minimally invasive form of management in selected cases of severe OHSS following ovulation induction. However, if pregnancy ensues, the syndrome persists for a longer period, and the clinical manifestations of severe OHSS could mask the picture of a bleeding gestational sac. It could be easily overlooked unless the possibility of an ectopic pregnancy is kept in mind in cases of severe OHSS exacerbated by early pregnancy with or without a previous ectopic pregnancy history. We report a case of severe OHSS with simultaneous bilateral tubal pregnancy following intrauterine insemination (IUI). A 31-year-old woman with polycystic ovarian disease developed severe OHSS during the therapeutic course of IUI. An emergent exploratory laparotomy was performed 14 days after admission, and the operative findings showed persistent profuse bleeding from the bilateral fimbrial ends with marked enlargement of the ampullary portions. A linear salpingotomy was performed by a longitudinal incision along the area of maximal distension of the dilated fallopian tubes to preserve her fertility. We recommend that in cases of severe OHSS exacerbated by early pregnancy, serial serum beta-hCG and transvaginal ultrasound follow-up may be necessary due to the potential association of severe OHSS in pregnancy with an ectopic pregnancy.
منابع مشابه
Ruptured ovarian cysts and bilateral pregnancy
iatrogenic condition with a varied spectrum of clinical and laboratory manifestations. The severe form is potentially lethal.1,2 Tubal ectopic pregnancy is a common, life-threatening situation in gynecology that requires rapid and accurate diagnosis and treatment. However, bilateral ectopic pregnancy is rare, varying in frequency between one per 725 and one per 1,580 ectopic pregnancies.3 We re...
متن کاملI-31: Antihistamine & Ovarian Hyperstimulation syndrome
Background: Ovarian hyperstimulation syndrome (OHSS) is a rare iatrogenic complication of ovulation stimulation. The pathogenesis of OHSS is uncertain. The crucial event appears to be an increase in capillary permeability by vasoactive mediators such as cytokine and histamine. The aim of this study is to evaluate the role of loratadine (antihistamine) in preventing ovarian hyperstimulation synd...
متن کاملCombined intra-uterine and extra-uterine pregnancy associated with mild hyperstimulation syndrome after clomiphene ovulation induction.
We report a combined intra-uterine and tubal pregnancy associated with mild ovarian hyperstimulation syndrome (OHSS) following ovulation induction by clomiphene. The diagnosis of ectopic pregnancy was originally missed until rupture occurred. OHSS confused the clinical picture, the important diagnostic feature being the fall in the haemoglobin concentration. The patient had a left partial salpi...
متن کاملSevere Spontaneous Ovarian Hyperstimulation Syndrome With Cervical İnsufficiency: A Case Report
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 r...
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ورودعنوان ژورنال:
- Chang Gung medical journal
دوره 27 2 شماره
صفحات -
تاریخ انتشار 2004