Becerril-Rodríguez PR, Ochoa-Contreras MP, Yoguez MT, Fragozo-Sandoval F

Language: Spanish
References: 20
Page: 109-113
PDF size: 445.09 Kb.

ABSTRACT

Introduction: The rate of live births that are conceived through assisted reproduction in the United States of America (USA) is greater than 1%; these techniques are associated with maternal complications, including ovarian hyperstimulation syndrome (OHSS); presenting an incidence of 1-5% per cycle of in vitro fertilization (IVF). Pulmonary thromboembolism (PTE) continues to be an important cause of maternal mortality, associated with failure to obtain the diagnosis. Our objective with this case report is to identify these conditions and to carry out early treatment of OHSS and PTE; since the physiological changes of this condition, in which cardiovascular and coagulation changes are included therefore, physicians may lead to an underdiagnosis. Case report: 37 year old female, G4, C3 with antecedent of in vitro fertilization (IVF); initiates current 15-day evolution of pain in right pelvic limb with visual analogue scale (EVA) 7/10; Doppler ultrasound: popliteal vein thrombosis, and partial flow. Adding, occasional mild dyspnea. After four hours, the patient presents with New York Heart Association (NYHA) IV dyspnea, class D, oliguria and cardiorespiratory arrest, which is reversed. Conclusions: Preventing, recognizing in time and adopting the therapeutic or preventive measures described make the difference to preserve the health of patients, the most serious form of OHSS can be complicated by multiple systemic disorders, these manifestations should be monitored in an Intensive Care Unit.

REFERENCES

1. Steward RG, Lan L, Shah AA, Yeh JS, Price TM, Goldfarb JM, et al. Oocyte number as a predictor for ovarian hyperstimulation syndrome and live birth: an analysis of 256,381 in vitro fertilization cycles. Fertil Steril 2014; 101(4): 967-73.

2. Garcia-Velasco JA, Pellicer A. New concepts in the understanding of the ovarian hyperstimulation syndrome. Curr Opin Obstet Gynecol 2003; 15(3): 251-6.

3. Gallo-Vallejo JL, Naveiro-Fuentes M, Puertas-Prieto A, Gallo-Vallejo FJ. Prevención del tromboembolismo venoso durante el embarazo y el puerperio en Atención Primaria y Especializada. Semergen 2016; 23. pii: S1138-3593(16)30198-8.

4. Cervantes E, Vallejo VV, Luna RRM, Sandler B. Síndrome de hiperestimulación ovárica. Actualización, ventajas de su diagnóstico y tratamiento oportuno. Rev Mex Med Repro 2014; 6(3): 158-68.

5. Azcona B, Campo G, Zabaleta J. Síndrome de hiperestimulación ovárica. Anales Sis San Navarra 2009; 32(Suppl 1): 19-27.

6. Tawfik MM, Taman ME, Motawea AA, Abdel-Hady E. Thrombolysis for the management of massive pulmonary embolism in pregnancy. Int J Obstet Anesth 2013; 22(2): 149-52.

7. Sucker C, Rainer B. Prophylaxis and treatment of venous thrombosis and pulmonary embolism in pregnancy. Reviews in Vascular Medicine 2015; 3(2): 24-30.

8. Brennan MC, Moore LE. Pulmonary embolism and amniotic fluid embolism in pregnancy. Obstet Gynecol Clin North Am 2013; 40(1): 27-35.

9. Caeiro AFC, Ramilo IDTM, Santos AP, Ferreira E, Batalha IS. Amniotic fluid embolism. Is a new pregnancy possible? Case report. Rev Bras Ginecol Obstet 2017.

10. Khalil A, Bowles L, O’Brien P, Cohen H. Systemic thromboembolism in pregnancy: venous thromboembolism. In: Cohen H, O’Brien P (eds.). Disorders of thrombosis and hemostasis in pregnancy: a guide to management. London: Springer-Verlag; 2015. pp. 81-104.

11. Kushner-Dávalos L. La fertilización in vitro: beneficios, riesgos y futuro. Rev Cient Cient Med 2010; 13(2): 77-80.

12. Leung AN, Charles J. Thromboembolic disease in pregnancy in Creasy and Resnik’s maternal-fetal medicine: principles and practice. Canada: Elsevier; 2014. pp. 906-17.

13. Lee My, Kim MY, Han JY, Park JB, Lee Ks, Ryu HM. Pregnancy-associated pulmonary embolism during the peripartum period: An 8-year experience at a single center. Obstet Gynecol Sci 2014; 57(4): 260-5.

14. Bagaria SJ, Bagaria VB. Strategies for diagnosis and prevention of venous thromboembolism during pregnancy. J Pregnancy 2011; 2011: 206858.

15. Gebril A, Hamoda H, Mathur R. Outpatient management of severe ovarian hyperstimulation syndrome: a systematic review and a review of existing guidelines. Hum Fertil (Camb) 2017; 29: 1-8.

16. Parilla BV, Fournogerakis R, Archer A, Sulo S, Laurent L, Lee P, et al. Diagnosing pulmonary embolism in pregnancy: are biomarkers and clinical predictive models useful? AJP Rep 2016; 6(2): e160-4.

17. Bajc M, Olsson B, Gottsäter A, Hindorf C, Jögi J. V/P SPECT as a diagnostic tool for pregnant women with suspected pulmonary embolism. Eur J Nucl Med Mol Imaging 2015; 42(8): 1325-30.

18. Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al. Corrigendum to: 2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 2015; 36(39): 2642.

19. Hirsh J, Hoak J. Management of deep vein thrombosis and pulmonary embolism. A statement for healthcare professionals. Council on Thrombosis (in consultation with the Council on Cardiovascular Radiology), American Heart Association. Circulation 1996; 93(12): 2212-45.

20. Fritz MA, Slemmons B. Inducción de la ovulación, síndrome de hiperestimulación ovárica. En: Endocrinología ginecológica clínica y esterilidad. 7a edición. Eds Wolters Kluwer Health España, S.A. 2007; 31: 1198-200.