Importance of medical imaging in ovarian hyperstimulation syndrome post suction and evacuation of H-mole: a rare case report and literature review

Sailendra Jha; Abhishek Shah; Deepa Shah; Prabhat B. Pande; Pragya Devkota; Amit K. Rauniyar; Amit Ghimire; Sandesh Poudel; Sunisha Vaidya; Alina Oli

doi:10.18203/2320-1770.ijrcog20260199

Authors

Sailendra Jha Department of Radiology, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
Abhishek Shah Department of Radiology, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
Deepa Shah Department of Internal Medicine, Manmohan Memorial College and Teaching Hospital, Kathmandu, Nepal
Prabhat B. Pande Department of Radiology, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
Pragya Devkota Department of Radiology, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
Amit K. Rauniyar Department of Radiology, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
Amit Ghimire Department of Radiology, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
Sandesh Poudel Department of Obstetrics and Gynecology, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
Sunisha Vaidya Department of Pathology, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal
Alina Oli Department of Research, Paropakar Maternity and Women’s Hospital, Kathmandu, Nepal

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20260199

Keywords:

Ovarian hyperstimulation syndrome, Hydatidiformmole, Gestational trophoblastic disease/neoplasia, β-HCG, Suction and evacuation, Dilatation and evacuation, Retained product of conception

Abstract

Hydatidiform mole (H-mole) is a gestational trophoblastic disorder caused by abnormal fertilization, often presenting with elevated β-HCG levels and abnormal uterine findings. A rare complication is spontaneous Ovarian Hyperstimulation Syndrome (OHSS), usually associated with fertility treatments but occasionally triggered by high endogenous β-HCG levels. We report a case of a 17-year-old primi-gravida who developed OHSS following suction and evacuation of a complete H-mole. Despite of initial management, she presented later with ovarian enlargement, lung nodules, and rising β-HCG, indicating high-risk gestational trophoblastic neoplasia (GTN) for which imaging played a key role in identifying complications. She responded well to EMA-CO chemotherapy with normalization of β-HCG. This case emphasizes the importance of post-evacuation monitoring and the critical role of imaging in diagnosing and managing rare but serious complications like spontaneous OHSS.

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