Severe OHSSY with ascites in IVF treatment: case report

Trajanova, Milka and Antovska, Vesna and Baldzieva, Sanja and Zlateska, Aleksandra and Filipovska, Marijana (2018) Severe OHSSY with ascites in IVF treatment: case report. In: XIX National Congress of infertility and reproductive health with international participation, 15-18 March 2018, Borovets, Bulgaria.

Text sterilitet, OHSSY, 2018.pdf Download (2MB)

Abstract

Ovarian hyperstimulation syndrome (OHSSy), especially severe OHSSy, is an iatrogenic and potentially life-threatening complication of assisted reproduction. Ascites is one of the clinical manifestations of severe OHSSy, which can lead to dyspnea, oliguria, distended abdomen and discomfort. The focus of attention in such cases is placed firmly upon the health of the patient, but also on insisting on achieving a healthy pregnancy as of a secondary importance.
We describe a case of severe OHSSy in a 29-year-old patient following an IVF et ET treatment and a long protocol of gonadotropin stimulation. The patient was admitted in our hospital at the Intensive Care Unit on the sixth day after an embryonic transfer in a severe clinical condition with dyspnea, distended abdomen above the chest wall, vulvar edema and oliguria. By the use of Ultrasound method ascitic fluid was confirmed in the abdomen and both ovaries were visibly enlarged with the presence of multiple follicles. The patient admissional hypoproteinemia was improved with 18 units of human albumins and 6 units of plasma. There were noticable laboratory deviations which were in addition of hyperkalaemia, hyponatremia, and severe hypercoagulable condition, after which appropriate anticoagulation therapy was administered at highly initial doses. Paracentesis was done four times with the largest evacuation of three litres of ascitic fluid at a time. This was followed by a significant decrease in abdominal discomfort and improvement in the urine output.
This case resulted in intrauterine gestational sac and beta-HCG values in the serum that increased proportionally and led to a healthy pregnancy. In the meantime, the pregnancy was monitored at another facility. The pregnancy ended in the thirty-third gestation week with a caesarean section and alive birth, when once again the patient was hospitalized in our facility with eclampsia.
Key words: OHSSy, IVF et ET, eclampsia.

Item Type:	Conference or Workshop Item (Paper)
Subjects:	Medical and Health Sciences > Clinical medicine
Divisions:	Faculty of Medical Science
Depositing User:	Sanja Baldzieva
Date Deposited:	03 Dec 2024 12:13
Last Modified:	03 Dec 2024 12:13
URI:	https://eprints.ugd.edu.mk/id/eprint/35109

Actions (login required)

View Item