Abstract
Background: Spontaneous ovarian hyperstimulation syndrome (sOHSS) is a rare condition in naturally conceived pregnancies, characterized by ovarian enlargement and extravascular fluid accumulation.
Case presentation: A 19-year-old Ethiopian woman, gravida III para I, presented at 10 weeks gestation with progressive abdominal swelling, ascites, and hypoxia (SpO2 92%). She had no history of fertility treatment. Ultrasound showed bilaterally enlarged ovaries (14×12 cm left, 12×10 cm right) with massive ascites and a viable intrauterine pregnancy. She was diagnosed with severe sOHSS and managed conservatively with intravenous fluids, thromboprophylaxis, and therapeutic paracentesis.
Conclusion: The patient had an uncomplicated antenatal course and delivered a healthy term newborn. This case highlights the importance of recognizing sOHSS in spontaneous pregnancies and the efficacy of conservative management, even in low-resource settings.
Keywords
Spontaneous ovarian hyperstimulation, Pregnancy, Conservative management, Ascites, First-trimester pregnancy