Stroke in ovarian hyperstimulation syndrome in early pregnancy treated with intra-arterial rt-PA.
Ovarian hyperstimulation syndrome (OHSS) caused by fertility medications can predispose women to thrombosis. The authors present a case of a previously healthy woman who underwent in vitro fertilization and experienced a middle cerebral artery thrombosis that was subsequently lysed with intra-arterial recombinant tissue plasminogen activator (rt-PA). To the authors' knowledge, this is the first reported case of successful use of rt-PA to lyse a cerebral arterial thrombus resulting from severe OHSS. The patient made a near complete neurologic recovery and delivered a healthy infant at term, illustrating that intra-arterial thrombolysis can be used with relative safety even in very early pregnancy.
Elford
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Department of Obstetrics & Gynecology, Division of Reproductive Medicine, Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
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Wee
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D000328:Adult; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000188:drug therapy; D007269:Injections, Intra-Arterial; D016471:Ovarian Hyperstimulation Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011247:Pregnancy; D011994:Recombinant Proteins / Q000627:therapeutic use; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator