Department of Obstetrics and Gynaecology, Imperial College Healthcare NHS Trust, London, UK
Department of Obstetrics & Gynaecology, Homerton University Hospital NHS Foundation Trust, London, UK.
BMJ Case Rep. 2020 Oct 31;13(10):e236950. doi: 10.1136/bcr-2020-236950.
A 32-year-old woman underwent a medical termination in the second trimester of a spontaneously conceived triploid pregnancy after developing early-onset preeclampsia with subsequent haemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. Placental histology was normal (non-molar) and unusually, she developed ovarian hyperstimulation syndrome (OHSS) 4 weeks later. She was managed conservatively following multidisciplinary team input to exclude malignant pathology. The rarity of late-onset spontaneous OHSS could have resulted in inappropriate surgical management. In the absence of supportive treatment there is also a risk of the condition progressing to a critical stage. Follow-up ultrasonography after termination of pregnancy should be considered for women with evidence of ovarian hyperstimulation, particularly if other risk factors for OHSS are present. Delayed-onset OHSS should be considered in women presenting with bilateral cystic ovarian enlargement after triploid pregnancy.
一位 32 岁女性因早发型子痫前期随后出现溶血、肝酶升高和血小板计数降低（HELLP）综合征而在自然受孕的三倍体妊娠中期接受了医疗终止。胎盘组织学正常（非葡萄胎），不同寻常的是，她在 4 周后出现卵巢过度刺激综合征（OHSS）。在多学科团队的输入下排除恶性病理后，她接受了保守治疗。晚发型自发性 OHSS 的罕见性可能导致了不适当的手术治疗。如果没有支持性治疗，病情也有可能进展到危急阶段。对于有卵巢过度刺激迹象的孕妇，特别是如果存在其他 OHSS 风险因素，在妊娠终止后应考虑进行超声随访。在三倍体妊娠后出现双侧囊性卵巢增大的女性中应考虑迟发型 OHSS。
