title: Ovarian salvage in bilaterally complicated severe ovarian hyperstimulation syndrome.
abstract: OBJECTIVE
  To report the management of 2 cases of severe ovarian hyperstimulation syndrome (OHSS) bilaterally complicated by rupture and late subsequent torsion.
  
  
  METHODS
  Two case reports.
  
  
  METHODS
  Obstetrics and Gynecology department of a hospital.
  
  
  METHODS
  Case 1: Severe OHSS complicated by massive intraperitoneal hemorrhage and bilateral extensive ovarian rents and rupture at multiple sites. Case 2: Twin IVF pregnancy and late severe OHSS complicated further by subsequent bilateral torsion.
  
  
  METHODS
  Case 1: Diagnosed by clinical, hematologic, and ultrasound findings. Resuscitation, laparotomy, and meticulous ovarian repair with suture, glue, and hemostat affected bilateral ovarian conservation. Case 2: Diagnosed clinically and confirmed by color Doppler. Left salpingoopherectomy was performed because of a devitalized left ovary; 3 days later laparoscopic right ovarian detorsion and aspiration was possible as early Doppler diagnosis was made.
  
  
  METHODS
  Case 1: ovarian conservation. Case 2: ovarian conservation and continuation of pregnancy.
  
  
  RESULTS
  Case 1: Recovery and normal serum FSH and E(2) 2 months postsurgery. Case 2: Continuation of pregnancy and the remaining ovary was healthy at abdominal delivery.
  
  
  CONCLUSIONS
  Two cases of bilaterally complicated severe OHSS in which the patients' safety and bilateral ovarian integrity were at jeopardy. The cases are presented to define the importance of awareness, early diagnosis, and intervention, as well as the use of various methods and techniques to affect preservation of ovarian integrity and reserve.
authors: Department of Obstetrics and Gynecology, Tawam Hospital in affiliation with Johns Hopkins Medicine, Al-Ain, United Arab Emirates. wafa_alomari@yahoo.com
authors: Wafa
authors: W
authors: Al Omari
authors: Saad
authors: S
authors: Ghazal-Aswad
authors: Islam H
authors: IH
authors: Sidky
authors: Maha Khalid
authors: MK
authors: Al Bassam
mesh_terms: D000291:Adnexal Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D000328:Adult; D002585:Cesarean Section; D005260:Female; D013509:Gynecologic Surgical Procedures; D006465:Hemoperitoneum / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006489:Hemostatic Techniques; D006801:Humans; D050498:Live Birth; D010049:Ovarian Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016471:Ovarian Hyperstimulation Syndrome / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D010052:Ovariectomy; D010062:Ovulation Induction / Q000009:adverse effects*; D011247:Pregnancy; D012422:Rupture, Spontaneous; D058994:Salpingectomy; D012720:Severity of Illness Index; D013396:Suction; D013536:Suture Techniques; D014102:Torsion Abnormality / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D016216:Ultrasonography, Prenatal; D055815:Young Adult