Acute Kidney Injury Complicating Ovarian Hyperstimulation Syndrome: A Case Report
DOI:
https://doi.org/10.30442/ahr.1002-12-240Abstract
Ovarian Hyperstimulation Syndrome (OHSS) is a known iatrogenic condition resulting predominantly from an exaggerated response to ovarian stimulation during fertility care. The pathology is characterized by increased capillary permeability, resulting in fluid leakage from the vascular compartment, with third-space fluid accumulation and haemoconcentration. We report a case of severe OHSS in a 33-year-old Para 0+2 woman following in-vitro fertilization and embryo transfer. She was presented with abdominal pain and distension, dyspnoea, jaundice, reduced urinary output as well as sonographic features of enlarged ovaries with ascites. She had a miscarriage 20 hours before the presentation and recovered fully with multidisciplinary treatment, including haemodialysis.
Though OHSS is rare and unpredictable, with varying morbidity and mortality rates, it is pertinent that proper patient selection, early diagnosis, and timely intervention may prevent or lessen some complications associated with this condition.
References
Alper MM, Smith LP, Sills ES. Ovarian hyperstimulation syndrome: current views on pathophysiology, risk factors, prevention, and management. J Exp Clin Assist Reprod 2009;6:3.
Palomba S, Costanzi F, Nelson SM, Caserta D, Humaidan P. Interventions to prevent or reduce the incidence and severity of ovarian hyperstimulation syndrome: a systematic umbrella review of the best clinical evidence. Reprod Biol Endocrinol 2023;21:67. http://doi.org/10.1186/s12958-023-01113-6
Naredi N, Talwar P, Sandeep K. VEGF antagonist for the prevention of ovarian hyperstimulation syndrome: Current status. Med J Armed Forces India 2014;70:58-63. http://doi.org/10.1016/j.mjafi.2012.03.005
Abou Arkoub R, Xiao CW, Claman P, Clark EG. Acute Kidney Injury due to ovarian hyperstimulation syndrome. Am J Kidney Dis 2019;73:416-420. http://doi.org/10.1053/j.ajkd.2018.10.010
Chae-Kim JJ, Roman R, Hawkins K, Gavrilova-Jordan L. Severe late-onset ovarian hyperstimulation syndrome presenting with liver dysfunction after in vitro fertilization: A case report. Case Rep Women Health 2021;31: e00332. http://doi.org/10.1016/j.crwh.2021.e00332
Jahromi BN, Parsanezhad ME, Shomali Z, Bakhshai P, Alborzi M, Vaziri NM, et al. Ovarian Hyperstimulation Syndrome: A Narrative Review of Its Pathophysiology, Risk Factors, Prevention, Classification, and Management. Iran J Med Sci.2018;43:248-260. http://doi.org/10.30476/ijms.2018.40535
Youssef MA, Mourad S. Volume expanders for preventing ovarian hyperstimulation syndrome. Cochrane Database Syst Rev. 2016;16:CD001302. http://doi.org/10.1002/14651858.CD001302.pub3
Kumar P, Sait SF, Sharma A, Kumar M. Ovarian hyperstimulation syndrome. J Hum Reprod Sci.2011;4:70-75. http://doi.org/10.4103/0974-1208.86080
Dawood AS, Elsharwy MA. Continuous versus intermittent paracentesis in severe ovarian hyperstimulation syndrome: A multicenter randomized clinical trial. J Reprod Biol Endocrinol 2017;1:23-28.
Fiedler K, Ezcurra D. Predicting and preventing ovarian hyperstimulation syndrome (OHSS): the need for individualized not standardized treatment. Reprod Biol Endocrinol 2012;10:1-10. http://doi.org/10.1186/1477-7827-10-32
Corbett S, Shmorgun D, Claman P. Prevention of Ovarian hyperstimulation syndrome. J Obstet Gynaecol Can 2016;38:512-524. http://doi.org/10.1016/S1701-2163(15)30417-5
D'Angelo A, Amso NN, Hassan R. Coasting (withholding gonadotropins) for preventing ovarian hyperstimulation syndrome. Cochrane Database Syst Rev 2017;5:CD002811. http://doi.org/10.1002/14651858.CD002811.pub4
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Annals of Health Research (The Journal of the Medical and Dental Consultants Association of Nigeria, OOUTH, Sagamu, Nigeria)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.