Ovarian salvage in bilaterally complicated severe ovarian hyperstimulation syndrome

Omari, Wafa Al; Ghazal-Aswad, Saad; Sidky, Islam; Bassam, Maha Khalid Al

doi:10.1016/j.fertnstert.2011.06.005

Cited by 15 publications

(6 citation statements)

References 11 publications

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“…Hemostasis with sutures or electrocautery may not be easy owing to the soft friable nature of the enlarged oedematous ovary. 4 In our case, the ovarian follicular wall had ruptured bilaterally resulting into extensive internal bleeding. Timely diagnosis, decision for exploratory laparotomy with liberal midline incision, extreme care while handling the friable enlarged ovaries and the meticulous suturing to achieve hemostasis resulted in bilateral ovarian preservation.…”

Section: Discussionmentioning

confidence: 62%

“…6 Ovarian rupture complicating OHSS is rare it may result from the rapidly enlarging vascular ovary with friable edematous stromal and cortical tissue. 4 Active bleeding arises from fissures between intact follicles and from deeper stromal vessels, or from enlarging follicular capsule as in our patient. 7 Diagnostic dilemma may be encountered because ruptured ectopic pregnancy or luteal cyst can also cause intraperitoneal hemorrhage.…”

Section: Discussionmentioning

confidence: 69%

“…3 These hyperstimulated ovaries may rarely rupture or undergo torsion, which often misdiagnosed and reported to range from 0.08% to 0.2%. 4 Surgical intervention maintaining ovarian integrity and reserve is challenging because of the friability of the tissue. We present a case with conservative surgical management of spontaneous hemoperitoneum following rupture of ovarian follicular vessel in a patient with OHSS.…”

Section: Introductionmentioning

confidence: 99%

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A case of ovarian hyperstimulation syndrome with spontaneous hemoperitoneum

Lele

Tangri

2017

Int J Reprod Contracept Obstet Gynecol

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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A case of ovarian hyperstimulation syndrome with spontaneous hemoperitoneum

Lele

Tangri

2017

Int J Reprod Contracept Obstet Gynecol

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“…[5] Torsion of the right adnexa is more common than left adnexal torsion. [6] However, bilateral adnexal torsion has also been reported.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic detorsion for bilateral ovarian torsion in a singleton pregnancy with spontaneous ovarian hyperstimulation syndrome

et al. 2014

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A 26-year-old primigravida with a singleton pregnancy of 9 weeks gestation presented with severe lower abdominal pain, following spontaneous hyperstimulation of the ovaries in a natural conception. Emergency laparoscopy was done and bilateral ovarian torsion with retained vascularity was noted. Bilateral detorsion with ovarian puncture and ovariopexy was performed. A review of international literature suggests that this is the first case reported with bilateral ovarian torsion following spontaneous ovarian hyperstimulation syndrome in a singleton pregnancy.

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“…Intractable OHSS has resulted in bilateral oophorectomy. 39 Surgery when indicated should be performed by an experienced surgeon. 40 Compromised obstetric outcome has been reported by many authors.…”

Section: Surgical Managementmentioning

confidence: 99%

Prevention and Management of Ovarian Hyperstimulation Syndrome

Rao¹,

Krishna²,

Agarwal³

2019

International Journal of Infertility &Amp; Fetal Medicine

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Ovarian hyperstimulation syndrome (OHSS) is a potential iatrogenic life-threatening situation. It is difficult to decipher OHSS pathophysiology. 1 The occurrence is directly proportional to estradiol in blood, follicle number, and human chorionic gonadotropin (hCG) with more chances of happening in polycystic ovarian disease. Complete prevention of OHSS is never possible, but endocrine profile and ultrasonographic follicular monitoring are the mainstay of its prediction. Complications such as hemoconcentration, hypovolemia, and thromboembolism can occur. Withholding hCG, continuation of gonadotropin-releasing hormone analogs, coasting, agonist trigger, intravenous albumin, dopamine agonists, and cryopreservation of embryos are cornerstones of OHSS prevention. 2 Mild OHSS usually requires no active therapy. Moderate and severe cases have to be treated. Surgery may be needed in ruptured ovarian cysts, torsion, or concomitant ectopic pregnancy. Transvaginal paracentesis is recommended in cases of severe ascites. Inpatient management is typically based on preventing complications such as derangement of kidney and liver functions, thrombosis, and severe respiratory depression. Recent ART treatment protocols behold more patient-friendly mild ovarian stimulation regimes that are individualized depending on patient's ovarian reserve. 3

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Ovarian salvage in bilaterally complicated severe ovarian hyperstimulation syndrome

Cited by 15 publications

References 11 publications

A case of ovarian hyperstimulation syndrome with spontaneous hemoperitoneum

A case of ovarian hyperstimulation syndrome with spontaneous hemoperitoneum

Laparoscopic detorsion for bilateral ovarian torsion in a singleton pregnancy with spontaneous ovarian hyperstimulation syndrome

Prevention and Management of Ovarian Hyperstimulation Syndrome

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