Publication:

Ovarian hyperstimulation syndrome in a spontaneous pregnancy: a diagnostic dilemma

Spontaneous ovarian hyperstimulation stimulation (sOHSS) is an extremely rare condition reported in a spontaneously/ naturally conceived pregnancy. It is most commonly associated with multiple gestation, hypothyroidism, and polycystic ovarian syndrome (PCOS). Severe form is a rare entity in a singleton pregnancy with spontaneous ovulation. These cases can very well be misdiagnosed as an acute abdomen in pregnancy and may lead to unnecessary exploratory laparotomy or a malignancy. The following case reports a 20-year-old female with a spontaneous normal singleton pregnancy presenting with acute abdomen, vomiting and distention of the abdomen. Ultrasonography reveals a 5.5-week viable intrauterine single fetus with bilateral multilocular cystic ovarian masses with ascites. The patient was managed conservatively with oral cabergoline and resolution of symptoms with eventual uncomplicated pregnancy.