Spontaneous Late Onset OHSS in Singleton Pregnancy in 2nd Trimester: A Rare Case.

Abstract

Ovarian hyperstimulation syndrome (OHSS) is a potentially life‐threatening complication of pharmacological ovarian stimulation. It is seen in approximately 2 % of all IVF cycles. The prevalence of moderate to severe OHSS ranges from 1 to 10 % in major IVF programs. Severe forms complicate 1 % of IVF cycles and are characterized by massive ovarian enlargement together with a fluid shift into extravascular compartments responsible for the development of ascites, sometimes pleural and/or pericardial effusion, hypovolemia, oliguria, and hydroelectrolytic disorders. In the most marked cases, thromboembolic phenomena may occur as a result of hemoconcentration and coagulation disturbances (Hollemaert et al. [1]). Spontaneous ovarian hyperstimulation (spontaneous OHSS) is extremely rare in naturally conceived pregnancies. OHSS in the absence of exogenous gonadotropins is very rare, and only a few cases have been reported in the literature. Spontaneous OHSS likely to occur at 8–14 weeks of gestation, while iatrogenic OHSS usually occurs earlier at 3–8 weeks of gestation [2]. Human chorionic gonadotropin (hCG) is thought to play a crucial role in the development of the syndrome. Severe forms are indeed restricted to cycles with exogenous hCG to induce ovulation or as luteal phase support or with endogenous pregnancy‐derived hCG (Delbaere et al. [3]). Here, we report a rare case of spontaneous 2nd trimester OHSS in 22-year-old primigravida.