Ovarian torsion and spontaneous ovarian hyperstimulation syndrome in a twin pregnancy: A case report

Núria Gil Navarro; Emma Garcia Grau; Sílvia Pina Pérez; Laia Ribot Luna

doi:10.1016/j.ijscr.2017.03.014

Ovarian torsion and spontaneous ovarian hyperstimulation syndrome in a twin pregnancy: A case report

Int J Surg Case Rep. 2017:34:66-68. doi: 10.1016/j.ijscr.2017.03.014. Epub 2017 Mar 15.

Authors

Núria Gil Navarro¹, Emma Garcia Grau², Sílvia Pina Pérez², Laia Ribot Luna²

Affiliations

¹ Department of Obstetrics and Gynecology, Corporació Sanitària Parc Taulí, Parc Tauli, 1, 08208 Sabadell, Spain. Electronic address: nuriagilnavarro43@gmail.com.
² Department of Obstetrics and Gynecology, Corporació Sanitària Parc Taulí, Parc Tauli, 1, 08208 Sabadell, Spain.

Abstract

Introduction: Ovarian hyperstimulation syndrome (OHSS) is extremely rare in spontaneous pregnancies. Spontaneous OHSS can result from glycoprotein hormones stimulating follicle-stimulating hormone receptors (FSHR).

Presentation of case: We report a twin pregnancy in which ovarian torsion and hemoperitoneum complicating OHSS were treated with left adnexectomy and aspiration. The only trigger for spontaneous OHSS in this case was high levels of chorionic gonadotropin hormone.

Discussion: Multiple pregnancy, gestational trophoblastic disease, primary hypothyroidism, thyroid-stimulating hormone/gonadotropin-secreting adenomas, and mutations of the FSHR gene may trigger spontaneous OHSS.

Conclusion: Spontaneous OHSS should be included in the differential diagnosis of acute abdomen in pregnant women; if spontaneous OHSS is diagnosed, the etiology should be determined in order to focus the treatment and avoid future complications.

Keywords: Case report; Hemoperitoneum; Laparoscopic adnexectomy; Spontaneous ovarian hyperstimulation syndrome; Twin pregnancy.