Archives of Gynecology and Obstetrics

, Volume 290, Issue 4, pp 803–806 | Cite as

Ovary hyperstimulation syndrome accompanying molar pregnancy: case report and review of the literature

  • Hirotada Suzuki
  • Shigeki MatsubaraEmail author
  • Shin-ichiro Uchida
  • Akihide Ohkuchi



To describe a naturally conceived woman with ovary hyperstimulation syndrome (OHSS) accompanying molar pregnancy and review the literature on this condition.


We report a 31-year-old 2 parous naturally conceived woman with OHSS accompanying partial molar pregnancy. Dilatation and evacuation (D&E) were performed at 10 weeks of gestation. The signs and symptoms of OHSS were the severest on day 8 after D&E, when hCG had already decreased. This case is reported in detail. We also review the literature.


A literature search yielded seven cases of this condition. Any type of molar pregnancy, i.e., complete, partial, or invasive, can accompany OHSS. The initial manifestation of OHSS occurred at a median of the 12th week of gestation (range 7–16), which may be later compared with OHSS caused by ovulation induction. In all cases, OHSS aggravated after D&E.


We must be aware that OHSS can occur during molar pregnancy, and can be exacerbated after D&E.


Dilatation and evacuation Human chorionic gonadotropin Molar pregnancy OHSS Ovary hyperstimulation syndrome 


Conflict of interest

We declare no conflicts of interest.

Patient anonymity


Informed consent



  1. 1.
    Alper MM, Smith LP, Sills ES (2009) Ovarian hyperstimulation syndrome: current views on pathophysiology, risk factors, prevention, and management. J Exp Clin Assist Reprod 6:3. Accessed 29 May 2014
  2. 2.
    Nastri CO, Ferriani RA, Rocha IA, Martins WP (2010) Ovarian hyperstimulation syndrome: pathophysiology and prevention. J Assist Reprod Genet 27:121–128PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Delbaere A, Smits G, Olatunbosun O, Pierson R, Vassart G, Costagliola S (2004) New insights into the pathophysiology of ovarian hyperstimulation syndrome. What makes the difference between spontaneous and iatrogenic syndrome? Hum Reprod 19:486–489PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Zhou X, Duan Z (2012) A case of ovarian hyperstimulation syndrome following a spontaneous complete hydatidiform pregnancy. Gynecol Endocrinol 28:850–852PubMedCrossRefGoogle Scholar
  5. 5.
    Rachad M, Chaara H, Zahra Fdili F, Bouguem H, Melhout A (2011) Ovarian hyperstimulation syndrome in a spontaneous pregnancy with invasive mole: report of a case. Pan Afr Med J 9:23. Accessed 29 May 2014
  6. 6.
    Strafford M, Morno-Ruiz N, Stubblefied P (2009) Ovarian hyperstimulation syndrome in a spontaneous pregnancy with a complete hydatidiform mole. Fertil Steril 92: 395.e1–3Google Scholar
  7. 7.
    Arora R, Merhi ZO, khulpateea N, Roth D, Minkoff H (2008) Ovarian hyperstimulation syndrome after a molar pregnancy evacuation. Fertil Steril 90: 1197.e5–7Google Scholar
  8. 8.
    Ludwig M, Germbruch U, Bauer O, Diedrich K (1998) Ovarian hyperstimulation syndrome (OHSS) in a spontaneous pregnancy with fetal anf placental triploidy: information about the general pathophysiology of OHSS. Hum Reprod 13:2082–2087PubMedCrossRefGoogle Scholar
  9. 9.
    Moneta E, Menini E, Scirpa P, Plotti G (1974) Urinary excretion of steroids in a case of hydatidiform mole with ascites. Obstet Gynecol 44:47–52PubMedGoogle Scholar
  10. 10.
    Hooper AA, Mascarenhas AM, O’Sullivan JV (1966) Gross ascites complicating hydatidiform mole. J Obstet Gynaecol Br Commonw 73:854–855PubMedCrossRefGoogle Scholar
  11. 11.
    Lee A, Christenson LK, Stouffer RL, Burry KA, Patton PE (1997) Vascular endothelial growth factor levels in serum and follicular fluid of patients undergoing in vitro fertilization. Fertil Steril 68:305–311PubMedCrossRefGoogle Scholar
  12. 12.
    Levin ER, Rosen GF, Cassidenti DL, Yee B, Meldrum D, Wisot A, Pedram A (1998) Role of vascular endothelial cell growth factor in ovarian hyperstimulation syndrome. J Clin Invest 102:1978–1985PubMedCentralPubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Hirotada Suzuki
    • 1
  • Shigeki Matsubara
    • 1
    Email author
  • Shin-ichiro Uchida
    • 1
  • Akihide Ohkuchi
    • 1
  1. 1.Department of Obstetrics and GynecologyJichi Medical UniversityShimotsukeJapan

Personalised recommendations