2-3 Clinical course after the OPU
Abdominal pain began the day after the OPU, and the patient lost consciousness twice on the 3rd day after the OPU, so she went to a hospital. A large amount of ascites, bilateral ovarian swelling (right: 56 × 69 mm, left: 62 × 45 mm), a heart rate of 110 bmp, and blood pressure of 70/50 mmHg were observed at the time of admission. The patient was immediately hospitalized and diagnosed with hypovolemic shock and severe OHSS.
No abnormal findings were detected by head magnetic resonance imaging. A blood test showed the following: albumin level of 2.8 g/dL, creatinine 0.84 mg/dL, sodium 134 mEq/L, potassium 5.5 mEq/L, AST 44 U/L, ALT 20 U/L, WBC 15,300/μL, hemoglobin 18.7 g/dL, and Ht 54.3%. A heparin and dopamine drip infusion was administered.
Her ascites increased from the 8th day after the OPU (6th day of hospitalization), and a puncture and drainage procedure was performed twice. On day 11 after the OPU, transvaginal ultrasonography showed a 10-mm gestational sac (GS) in the uterus, and her blood hCG level was 6990 mIU/mL. She was then discharged from the hospital on the 17th day after the OPU without any increase in ascites. After discharge, the course of her pregnancy was uneventful, and she gave birth to a female neonate (3136 g) at 40 weeks+1. At a 1-month postnatal examination, the infant was healthy without complications.