Severe Ovarian Hyperstimulation Syndrome Complicated by <i>Stenotrophomonas maltophilia</i> Peritonitis: A Case Report and Literature Review

Abstract

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic disorder resulting from ovulation induction. Although the occurrence of this disorder is rare, it can be potentially life-threatening in its most severe forms. We herein present the case of a young nulliparous woman who presented with features of abdominal compartment syndrome and was subsequently diagnosed with severe OHSS. All physicians, in particular critical care doctors, must be aware of this rare, but potentially life-threatening iatrogenic disorder.

Management of ovarian hyperstimulation syndrome with abdominal compartment syndrome, based on intravesical pressure measurement

“…Ovarian hyperstimulation syndrome (OHSS) is primarily an iatrogenic disease that is characterized by an exaggerated response to ovulation induction therapy . This iatrogenic complication results from a loss of control of ovarian stimulation and can occur with any agent that is used to induce ovulation . Ovarian hyperstimulation syndrome consists of a variety of symptoms and signs, including ovarian enlargement, third‐space fluid collection, hemoconcentration, pleural effusion, ascites, and abdominal discomfort subsequent to increased vascular permeability …”

“…Increased pressure in the abdominal cavity can lead to compromised organ perfusion, similar to the compartment syndrome in limbs, which is a potentially life‐threatening condition . However, there are only a few reports of OHSS that is complicated with ACS …”

“…1 This iatrogenic complication results from a loss of control of ovarian stimulation and can occur with any agent that is used to induce ovulation. [1][2][3][4] Ovarian hyperstimulation syndrome consists of a variety of symptoms and signs, including ovarian enlargement, thirdspace fluid collection, hemoconcentration, pleural effusion, ascites, and abdominal discomfort subsequent to increased vascular permeability. 1,2,5 The treatment of OHSS usually requires i.v.…”

“…7,8 However, there are only a few reports of OHSS that is complicated with ACS. 3,6,9 Here, a case is reported in which intravesical pressure measurement was useful in the management of a patient who was diagnosed with severe OHSS that was complicated with ACS.…”

Clinical and Laboratory Assessment of Supplementation with Marine Collagen Peptides and Selected Antioxidants in Men with Mild-to-Moderate Erectile Dysfunction

“…The incidence of mild OHSS is 20%-33% within all in vitro fertilization (IVF) cycles, an incidence of 3%-6% for moderate OHSS and severe OHSS occurring in 0.1%-2% of cycles [3]. The mortality rate of OHSS is low, with an estimated incidence at 1:400 000-1:500000, and the incidence of hospitalization is 1.8% [3,4].…”