Tubercular Ascites Simulating Ovarian Hyperstimulation Syndrome following In Vitro Fertilization and Embryo Transfer Pregnancy

Amar Ramachandran,Rajeshwari G Bhat,Lorraine Simone Dias,Raviraj Acharya,Pratap Kumar,Naveen Manohar,Padmaja Raghavan,Anita Eipe

doi:10.1155/2013/176487

Amar Ramachandran, Rajeshwari G Bhat + Show 6 more

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https://doi.org/10.1155/2013/176487

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Abstract

Ovarian hyperstimulation syndrome (OHSS) is a known complication of using ovulation induction drugs in assisted reproductive techniques. Its incidence and severity vary. Tuberculosis is a very common disease in the developing world, and ascites is one of its sequelae. The newer aids in diagnosing tuberculosis include measuring levels of Adenosine DeAminase (ADA) in the third-space fluids or serum. This case report is from a tertiary care center, reflecting how tubercular ascites simulated OHSS, and the right diagnosis was made and managed. This is being presented due to its rarity.

Highlights

Ovarian hyperstimulation syndrome (OHSS) is a well-known complication of assisted reproductive techniques (ARTs) and is characterized by enlargement of the ovaries and fluid shift from the intravascular compartment to the third space [1]
We report a case of a 31-year-old lady who presented with tubercular ascites that simulated ovarian hyperstimulation (OHSS)
Ascites did not subside even with albumin and Cabergoline; other causes of ascites were evaluated by Mantoux test and chest X-ray, which were negative for tuberculosis

Summary

Introduction

Ovarian hyperstimulation syndrome (OHSS) is a well-known complication of assisted reproductive techniques (ARTs) and is characterized by enlargement of the ovaries and fluid shift from the intravascular compartment to the third space [1]. We report a case of a 31-year-old lady who presented with tubercular ascites that simulated ovarian hyperstimulation (OHSS). An ultrasound scan done showed an empty uterine cavity, indicating a complete abortion She had fever at the time, and a course of antibiotics was given. Her hemoglobin levels were low, for which she was given a unit of packed red blood cells. She was a booked case with us and had a past history of two episodes of ascites (OHSS) following the embryo transfer. Ascites did not subside even with albumin and Cabergoline; other causes of ascites were evaluated by Mantoux test and chest X-ray, which were negative for tuberculosis

ISRN Obstetrics and Gynecology

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