Hyperreactio Luteinalis: a Case of Ovarian Resection

Choi, S H; Lee, G C; Kim, S H

Abstract

Hyperreactio luteinalis[HL] refers to bilateral cystic enlargement of the ovaries during pregnancy due to benign hyperplastic luteinization of ovarian theca cells probably as a consequence of elevated hCG production or abnormal ovarian response to hCG. It is usually associated with gestational trophoblastic disease, Rh immunization, and multifetal pregnancy. As its clinical course is benign, leading to postpartum spontaneous regression, conservative management reserving ovary is more appropriate except the cases in which ovarian resection is indicated to control hemorrhage or to remove infarcted tissue. However, maternal respiratory decompensation or fetal growth restriction due to huge cystic ovaries which do not respond to conservative management may require ovarian resection. We report a case of HL that was diagnosed initially at 14 weeks gestation, managed conservatively without clinical improvement, and required bilateral ovarian resection at 17 weeks gestation for the risk of fetal growth restriction from huge ovarian masses.