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Case Report Open Access

A Case of Spontaneous Ovarian Hyperstimulation Complicating First-Trimester Pregnancy

  • 1Haramaya University Hospital, Oromiya, Ethiopia
  • 2Department of Radiology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
  • 3Department of Internal Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia
  • 4Department of Internal Medicine, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
+ Affiliations - Affiliations

Corresponding Author

Henok Bahru Wodajeneh, h0913129050@gmail.com

Received Date: February 08, 2026

Accepted Date: April 17, 2026

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

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