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Federación Mexicana de Ginecología y Obstetricia, A.C.

2021, Number 04

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Ginecol Obstet Mex 2021; 89 (04)

Unilateral pleural effusion like sole manifestation of the ovarian hyperstimulation syndrome in the context of a treatmnet of in vitro fertilization

Castillo I, García-Lozano JC, Guisado-Fernández J, Rosales C, Ruiz-Fernández I, Antiñolo-Gil G

Language: Spanish
References: 22
Page: 343-349
PDF size: 287.35 Kb.


ABSTRACT

Background: Ovarian hyperstimulation syndrome is a complication of fertility treatments such as in vitro fertilization, characterized by increased vascular permeability causing an accumulation of fluid in the extravascular space, mainly in the abdomen. Pleural effusion is a rare presentation form, usually associated with ascites and severe cases of SHO; there are very few documented cases in the literature in which unilateral pleural effusion occurs in isolation, and its presentation is frequently unpredictable.
Clinical case: 41-year-old patient who underwent an IVF cycle and consulted the emergency room for right pleuritic pain and dyspnea, associated with cough, present- ing an oxygen saturation of 94%. Auscultation showed absence of vesicular murmur in the right hemithorax. A transthoracic ultrasound was performed in the emergency department, showing a right pleural effusion, evacuating 1300cc. Abdominal ultrasound showed little free fluid and ovaries with a hyperstimulated appearance. Laboratory tests showed a leukocytosis of 19.41 x 10 ^ 3 / µL, a hematocrit of 38%, and normal liver and kidney functions. She was treated with intravenous albumin and strict fluid balance. She required two more evacuating thoracenteses to control symptoms. She is currently in the third trimester of a twin gestation.
Conclusion: Given the increased use of fertility treatments, it is important to suspect this condition in patients with a history, who consult for respiratory symptoms even in the absence of abdominal symptoms for proper management by specialized units.


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