[Thrombosis in ovarian hyperstimulation syndrome]
S P Prem Sukul1, Judith E Pekelharing, Marcel H A van Hooff
1Sint Franciscus Gasthuis, Rotterdam.
Nederlands Tijdschrift Voor Geneeskunde
|May 29, 2014
Summary
Ovarian hyperstimulation syndrome (OHSS) can lead to serious upper extremity venous thrombosis weeks after initial treatment. Extended thromboprophylaxis is crucial for severe OHSS patients post-discharge to prevent these rare but dangerous clots.
Area of Science:
- Reproductive Endocrinology
- Vascular Medicine
- Thrombosis Research
Background:
- Ovarian hyperstimulation syndrome (OHSS) is a rare but significant complication of in vitro fertilization (IVF).
- Severe OHSS increases the risk of thrombo-embolic events, often manifesting weeks after symptom resolution.
- Upper extremity venous thrombosis is a predominant, yet uncommon, presentation of OHSS-related vascular complications.
Observation:
- A 34-year-old woman presented with neck pain and right arm swelling/discoloration.
- She had been hospitalized six weeks prior for shortness of breath due to OHSS-induced pleural effusion.
- Clinical presentation led to the diagnosis of jugular and subclavian vein thrombosis.
Findings:
- The case highlights a rare instance of upper extremity deep vein thrombosis (DVT) secondary to OHSS.
- Diagnosis was confirmed, and the patient was treated with therapeutic low-molecular-weight heparin.
- This underscores the potential for delayed venous thrombotic events in severe OHSS.
Implications:
- Venous thrombosis is a rare but serious sequela of OHSS, necessitating vigilant monitoring.
- Extended thromboprophylaxis post-discharge is recommended for patients hospitalized with severe OHSS.
- Awareness of upper extremity DVT as a potential complication can guide timely diagnosis and management.
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