Hyperreactio Luteinalis in the Third Trimester Complicating Fetal Hydrops and Mirror Syndrome

Abstract

Hyperreactio luteinalis (HL) is a benign condition marked by bilateral ovarian cystic enlargement. It is rare and understanding its presentation will prevent unnecessary surgical intervention. A 21-year-old G1P0 with a spontaneous singleton pregnancy complicated by non-immune fetal hydrops and mirror syndrome developed abdominal pain and dyspnea. She underwent therapeutic amnioreduction at 31 3/7 weeks gestation due to presumed symptomatic polyhydramnios. An obstetric ultrasound showed large bilateral ovarian masses, maternal ascites, and a left pleural effusion. Due to abnormal fetal Dopplers, she underwent a cesarean section and ovarian biopsies at 31 4/7 weeks gestation. Pathology revealed bilateral corpus luteal cysts. New onset bilateral ovarian masses associated with HL can be seen in spontaneous pregnancies complicated by fetal hydrops and mirror syndrome, and are best treated conservatively. J Clin Gynecol Obstet. 2017;6(2):41-44 doi: https://doi.org/10.14740/jcgo439w