From the Department of Forensic Pathology, China Medical University School of Forensic Medicine, Shenyang, Liaoning Province.
Kizilsu Kirgiz Autonomous Prefecture Public Security Bureau, Xinjiang Uygur Autonomous Region, China.
Am J Forensic Med Pathol. 2021 Mar 1;42(1):88-91. doi: 10.1097/PAF.0000000000000601.
Ovarian hyperstimulation syndrome (OHSS) is a rare iatrogenic disorder associated with controlled ovarian stimulation during assisted reproductive technology. Severe OHSS may impose serious complications, including pleural effusion, acute renal insufficiency, venous thrombosis, and even death, although lethal outcomes are rare in forensic practice. The reported incidence of severe OHSS ranges from 0.008% to 10%. Herein, we present the case of a 29-year-old woman who diagnosed with polycystic ovary syndrome and infertility chose to undergo assisted reproduction. She received leuprorelin acetate and follicle stimulating hormone prior to egg retrieval. Three days after the retrieval procedure, she developed abdominal pain and distension. Later that same day, she died unexpectedly. The subsequent autopsy revealed turbid effusions of pleural and peritoneal cavities, abnormal ovarian enlargement, and duskiness of multiple organ surfaces. Microscopic examination disclosed edema and hemorrhage in follicles of both ovaries, thrombosis within the myocardial matrix, and massive pulmonary edema. Routine toxicology screening was negative. The death was attributed to severe OHSS. This case provides a morphologic reference for clinical and forensic work. Autopsy findings in instances of severe OHSS provide valuable insight into the mechanisms and pathogenesis of this disease.
卵巢过度刺激综合征（OHSS）是一种罕见的医源性疾病，与辅助生殖技术中控制性卵巢刺激有关。严重的 OHSS 可能会导致严重的并发症，包括胸腔积液、急性肾功能不全、静脉血栓形成，甚至死亡，尽管在法医学实践中致死病例很少见。严重 OHSS 的报告发生率为 0.008%至 10%。本文报道了 1 例 29 岁女性，诊断为多囊卵巢综合征和不孕，选择接受辅助生殖。她在取卵前接受了醋酸亮丙瑞林和促卵泡激素治疗。取卵后 3 天，她出现腹痛和腹胀。当天晚些时候，她意外死亡。随后的尸检显示胸腔和腹腔中有混浊的积液，卵巢异常增大，多个器官表面呈暗褐色。显微镜检查显示两个卵巢的卵泡水肿和出血、心肌基质内血栓形成以及大量肺水肿。常规毒理学筛查为阴性。死因被归结为严重 OHSS。该病例为临床和法医工作提供了形态学参考。严重 OHSS 病例的尸检结果为该疾病的机制和发病机制提供了有价值的见解。
