Use of Point-of-Care Ultrasound for the Diagnosis of Ovarian Hyperstimulation Syndrome

J Emerg Med. 2017 Apr;52(4):e101-e104. doi: 10.1016/j.jemermed.2016.11.026. Epub 2016 Dec 18.


Background: Ovarian hyperstimulation syndrome (OHSS) occurs when ovaries are overstimulated and enlarged due to fertility treatments resulting in a shift of serum from the intravascular space to the third space, mainly the abdominal cavity. It is the most serious complication of ovarian hyperstimulation for assisted reproduction.

Case report: We present the case of a 40-year-old woman who presented with abdominal bloating and nausea 2 weeks after undergoing in vitro fertilization (IVF); she was diagnosed by an outside radiology ultrasound as having a ruptured ovarian cyst. A point-of-care emergency ultrasound performed by the emergency physician made the diagnosis of ovarian hyperstimulation syndrome. This led to more expedient management and obstetrical consultation. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Abdominal bloating and nausea are common presenting complaints in pregnant women. OHSS is a rare but potentially fatal complication of IVF. Recognition and early diagnosis by the emergency physician can lead to appropriate intervention and consultation.

Keywords: bedside ultrasound; emergency ultrasound; ovarian hyperstimulation syndrome; point of care ultrasound.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Adult
  • Analgesics / pharmacology
  • Analgesics / therapeutic use
  • Emergency Service, Hospital / organization & administration
  • Female
  • Fertilization in Vitro / adverse effects*
  • Fluid Therapy / methods
  • Humans
  • Infertility / therapy
  • Morphine / pharmacology
  • Morphine / therapeutic use
  • Nausea / etiology
  • Ovarian Hyperstimulation Syndrome / diagnosis*
  • Ovarian Hyperstimulation Syndrome / diagnostic imaging
  • Ovarian Hyperstimulation Syndrome / physiopathology
  • Point-of-Care Systems*
  • Pregnancy
  • Ultrasonography / methods*


  • Analgesics
  • Morphine