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Pleural effusion is an abnormal fluid accumulation in the pleural cavity, a narrow space between the lungs and the chest wall. It is not a disease per se but rather a symptom or indication of an underlying disease. In normal circumstances, this space contains a small amount of fluid (5 to 15 mL), a lubricant facilitating the non-frictional movement of the pleural surfaces.
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Pleural effusion following ovarian hyperstimulation.

Jader Joel Machado Junqueira¹, Ricardo Helbert Bammann, Ricardo Mingarini Terra

¹Clínica de Cirurgia Torácica, Hospital Sírio-Libanês, São Paulo, SP, Brazil. jader_junqueira@yahoo.com.br

Jornal Brasileiro De Pneumologia : Publicacao Oficial Da Sociedade Brasileira De Pneumologia E Tisilogia

|July 12, 2012

Summary

Ovarian hyperstimulation syndrome (OHSS) can cause severe pleural effusion, particularly in patients undergoing in vitro fertilization. Prompt diagnosis and drainage management lead to excellent outcomes, even with significant fluid accumulation.

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Area of Science:

Reproductive Endocrinology
Pulmonology
Critical Care Medicine

Background:

Ovarian hyperstimulation syndrome (OHSS) is a complication of ovulation induction, potentially leading to severe respiratory distress.
Pleural effusion is a recognized but possibly underdiagnosed manifestation of OHSS.

Observation:

This study details three cases of symptomatic pleural effusion in patients undergoing in vitro fertilization (IVF).
Patients presented with bilateral pleural effusions 27-60 days post-hormone therapy, requiring hospitalization, fluid resuscitation, and mechanical ventilation in two cases.
Initial thoracentesis was followed by pigtail catheter drainage due to early recurrence.

Findings:

Despite high fluid output (mean 1,000 mL/day) and prolonged drainage (9-22 days), all patients achieved excellent outcomes.
Early diagnosis and supportive care, including pleural drainage, were crucial for recovery.

Implications:

Pleural effusion secondary to OHSS, though potentially underdiagnosed, carries significant morbidity and requires careful management.
Effective supportive measures and timely pleural drainage can lead to favorable outcomes in affected patients, including those who are potentially pregnant.