A 26 year old infeile PCOS patient, treated with ovulation induction with clomiphene citrate, presents with sudden onset of abdominal pain and distension with ascites after 20 days of staing the tratment. what is the probable cause ?
OHSS is a medical complication that is completely iatrogenic and unique to stimulatory infeility treatment. Its symptoms are the result of ovarian enlargement and fragility, extravascular fluid accumulation, and intravascular volume depletion Vascular endothelial growth factor , whose expression in granulosa cells and serum is augmented by hCG, and a variety of other inflammatory cytokines have been implicated in the pathogenesis of this disease This tends to be more severe with multiple gestation Clinical feature:- Abdominal distension, Abdominal pain, Nausea and vomiting. Management : Intravascular fluid intake to replenish the volume Symptomatic treatment , like tapping of the ascites and pleural effusion
Uterine rupture
Ectopic pregnancy rupture
Multifetal pregnancy causing uterine distention
Ovarian Hyperstimulation syndrome
Infeility (Eggs'plantation!)