Department of Obstetrics and Gynecology, Hezhang County People's Hospital, Bijie City, Guizhou Province, China.
Department of Reproductive, Guizhou Provincial People's Hospital, Guiyang City, Guizhou Province, China.
Medicine (Baltimore). 2023 Jul 7;102(27):e34238. doi: 10.1097/MD.0000000000034238.
Ovarian hyperstimulation syndrome (OHSS) is a common complication during assisted conception treatment, mostly seen in patients with ovarian hyperresponsiveness such as polycystic ovary syndrome, especially in post-invitro fertilization and embryo transfer (IVF-ET) pregnancies. Its main symptoms are abdominal distension, abdominal pain, nausea and vomiting with ascites, pleural fluid, leukocytosis, hemoconcentration and hypercoagulation. This disease is a self-limiting disease and can be gradually cured by rehydration, albumin infusion and correction of electrolyte disorders in moderate to severe cases. Luteal rupture is a more common gynecological emergency abdomen. The combination of twin pregnancy, OHSS and ruptured corpus luteum is very rare. We successfully avoided the stimulation of the risk of pregnancy abortion by surgical exploration through dynamic ultrasound monitoring and vital signs observation in the absence of experience in primary care, and the patient hard-won twin pregnancy was successfully treated conservatively.
The patient is a 30-year-old post-IVF-ET woman with an established twin pregnancy, OHSS and sudden onset of lower abdominal pain.
Twin pregnancy, OHSS combined with ruptured corpus luteum.
Rehydration, albumin infusion, low molecular heparin for thromboprophylaxis, luteinizing support, ambulatory ultrasound monitoring.
After more than 10 days of standardized treatment for OHSS, dynamic ultrasound monitoring and close observation of vital signs, the patient was discharged cured of her condition and is continuing her pregnancy.
Our case shows that the possibility of acute abdominal rupture of the corpus luteum is still present in the case of combined OHSS in pregnancy, and that some patients with corpus luteum rupture can heal spontaneously during close testing to avoid the increased risk of miscarriage with surgical exploration.
卵巢过度刺激综合征（OHSS）是辅助受孕治疗中常见的并发症，主要见于卵巢高反应性患者，如多囊卵巢综合征，尤其是在体外受精和胚胎移植（IVF-ET）后妊娠。其主要症状为腹胀、腹痛、恶心呕吐伴腹水、胸腔积液、白细胞增多、血液浓缩和高凝状态。这种疾病是一种自限性疾病，中重度病例通过补液、白蛋白输注和纠正电解质紊乱可逐渐治愈。黄体破裂是一种常见的妇科急腹症。双胎妊娠、OHSS 和黄体破裂同时发生的情况非常罕见。我们在没有初级保健经验的情况下，通过动态超声监测和生命体征观察，成功避免了手术探查带来的流产风险刺激，成功地对这名患者来之不易的双胎妊娠进行了保守治疗。
患者是一名 30 岁的 IVF-ET 后妇女，确诊为双胎妊娠、OHSS 并突发下腹痛。
双胎妊娠、OHSS 合并黄体破裂。
补液、白蛋白输注、低分子肝素预防血栓形成、黄体支持、门诊超声监测。
经过 10 多天的 OHSS 标准化治疗，动态超声监测和密切观察生命体征，患者治愈出院，继续妊娠。
我们的病例表明，在妊娠合并 OHSS 的情况下，仍存在黄体破裂急性腹部破裂的可能性，一些黄体破裂患者在密切监测下可自发愈合，从而避免手术探查带来的增加流产风险。
