Case report on spontaneous ovarian hyperstimulation syndrome following natural conception associated with primary hypothyroidism
A 22 year old primigravida with spontaneous conception, regular menstrual cycles, married for 3 months and no relevant past medical illness, no clinical or subclinical evidence of hypothyroidism in the past; attended the Department of Obstetrics at 7 weeks of gestation. She was asymptomatic, and ultrasound scan also revealed single live intrauterine pregnancy at 7 weeks and normal appearing ovaries. At 9 weeks of gestation, she developed vomiting, diarrhoea and lower abdominal discomfort. Abdominal examination revealed a non-tender, mobile mass of approximately 10 cm × 10 cm in the right iliac fossa with no clinical evidence of ascites.\nUltrasound scan performed at 9 weeks of gestation revealed a single live intrauterine gestation corresponding to 9 weeks of gestation, bilaterally enlarged multicystic ovaries with right ovary measuring 10 cm × 8 cm, left ovary 8 cm × 6 cm and no ultrasonological evidence of ascites, pleural or pericardial effusion [Figures and ].\nStarted with levothyroxin 150 μg daily. The abdominal discomfort reduced from 14th week onward and the size of the ovaries normalized at 20 weeks. At 17 weeks of gestation, triple screening was performed, and the report showed low risk (1/6500) for chromosomal aneuploidies. Anomaly scan done at 20 weeks showed no fetal or placental anomalies and bilateral maternal ovaries were normal sized.\nThe patient delivered a term female baby weighing 3300 g at 39 weeks of gestation.