Lifesaving dose increment of cabergoline in life-threatening spontaneous ovarian hyperstimulation syndrome resistant to all interventions

Abstract

Objective: Spontaneous ovarian hyperstimulation syndrome (SOHSS) is an extremely rare complication that deserves a multidisciplinary approach together with a thorough investigation for the correct diagnosis of the underlying pathology. The aim of this study was to present a case of severe SOHSS resistant to all interventions and to discuss the available interventions to overcome such a rare and serious clinical situation.

Case report: We report a case of severe, life-threatening spontaneous OHSS with a normal nine weeks singleton pregnancy in a 25-year-old nulliparous woman, which resulted with pregnancy termination and continuation of disease progression until the dose of cabergoline was increased to 1.5 mg/day.

Conclusion: This case report emphasizes that patients with life-threatening SOHSS resistant to all medical and surgical interventions may benefit from higher doses of cabergoline. Although spontaneous OHSS is extremely rare, it is potentially a life-threatening clinical entity in its severe form and needs time management and detailed examination of the underlying causes.

摘要

目的：自发性卵巢过度刺激综合征(SOHSS)是一种极其罕见的并发症, 需要多学科的深入研究其潜在的病理并作出正确诊断。本研究的目的是提出一个所有干预措施都无效的严重的SOHSS, 并讨论现有的干预措施, 以克服这种罕见和严重的临床情况。

病例报告：我们报告一例年龄25岁、正常单胎妊娠9周的初次妊娠妇女发生严重的、危及生命的自发性OHSS, 最终导致妊娠终止, 病情持续恶化, 直到卡麦角林的剂量增加到1.5 mg/d患者才脱离危险。

结论：本病例报告强调, 更高剂量的卡麦角林可能对所有医疗和外科干预措施都无效的危及生命的SOHSS患者有益。虽然自发性OHSS非常罕见, 但其病情危重, 是一种潜在的危及生命的临床实体, 需要合理的时间管理及仔细检查其潜在病因。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Spontaneous ovarian hyperstimulation syndrome
• singleton pregnancy
• pregnancy termination
• cabergoline

Disclosure statement

No potential conflict of interest was reported by the authors.