Spontaneous ovarian hyperstimulation syndrome in early singleton pregnancy with hepatic involvement: two case reports of atypical presentations

To present two cases of spontaneous ovarian hyperstimulation syndrome (OHSS) with hepatic involvement in early singleton pregnancies.

Case Report: Two cases of spontaneous OHSS were reported, detailing clinical presentations, imaging findings, and management strategies.

Both cases involved young women in early singleton pregnancies presenting with abdominal symptoms and abnormal liver function tests.
Imaging revealed markedly enlarged ovaries and cholelithiasis in both cases, with no evidence of primary hepatic pathology in the first case.
One patient required laparoscopic cholecystectomy due to symptomatic biliary disease.

Spontaneous OHSS should be considered in pregnant patients with abdominal symptoms, ovarian enlargement, and abnormal liver function tests.

The relationship between spontaneous OHSS and hepatic abnormalities remains incompletely understood.
Further studies are needed to characterize the hepatic manifestations and underlying mechanisms.

These cases highlight the occurrence of spontaneous OHSS in early pregnancy and its potential hepatic complications.