Hyperreactio luteinalis in a monochorionic twin pregnancy complicated by preeclampsia: A case report

Area of Science:

• Obstetrics and Gynecology
• Reproductive Endocrinology

Background:

• Hyperreactio luteinalis (HL) is a rare, benign ovarian hyperstimulation condition during pregnancy.
• It is characterized by bilateral ovarian enlargement and can present with hyperandrogenism.

Observation:

• A case of spontaneous monochorionic diamniotic twin pregnancy with early-onset preeclampsia and suspected twin-twin transfusion syndrome.
• Bilateral enlarged ovarian masses were noted, measuring significantly large, with multiple thin-walled cysts.

Findings:

• The patient underwent dilation and evacuation for suspected complications.
• Postoperatively, elevated androgen levels were observed, which spontaneously resolved, confirming the clinical diagnosis of HL.
• HL is associated with multiple gestations, preeclampsia, and twin-twin transfusion syndrome.

Implications:

• HL should be considered in the differential diagnosis of adnexal masses during pregnancy.
• The condition typically requires expectant management and spontaneously regresses after delivery.
• This case underscores the importance of recognizing HL in complex twin pregnancies.