Severe ovarian hyperstimulation syndrome with with pleural and pericardial effusion

Abstract

As the number of couples receiving infertility treatment using assisted reproductive technology increases, it is important to be aware of the risks, one of the most serious being the hyperstimulation syndrome. Ovarian hyperstimulation syndrome (ОHS) is an iatrogenic condition resulting from the use of exogenous gonadotropins to induce the production of multiple eggs. Although the occurrence of this disorder is rare, it can be potentially life-threatening in its most severe forms. It is characterized by increased capillary permeability and fluid retention in the third space, nausea, vomiting, bloating, abdominal pain, tachycardia, tachypnea, and shortness of breath. Massive extravascular exudation leads to intravascular hypovolemia with the development of edema, ascites, pleural and pericardial effusion, hypovolemic shock, oliguria and electrolyte imbalance. Induced hemoconcentration leads to hypercoagulation and carries a risk of life-threatening thrombosis. We present a case of a woman admitted to an emergency room with shortness of breath and fainting, ascites, pleural effusions and pericardial effusion and subsequently diagnosed with severe ovarian hyperstimulation syndrome and taken to the intensive care unit. Early recognition, diagnosis and treatment of the syndrome reduces the risk of developing complications. This condition is life-threatening and patients need hospital treatment. The purpose of this publication is to raise awareness of this rare clinical condition.