Hyperreactio luteinalis is the endogenous form of the ovarian hyperstimulation syndrome (previous section), usually associated with excessive levels of human chorionic gonadotropin (hCG).


Clinical scenarios:

(1) hydatidiform mole or choriocarcinoma with elevated serum hCG levels

(2) fetal hydrops with elevated serum hCG levels

(3) multiple gestations (twins, triplets, etc.) with elevated serum hCG levels

(4) single pregnancy with normal hCG levels


There is bilateral ovarian enlargement secondary to numerous luteinized follicles in the cortex.

(1) Moderate to massive pelvic masses may be felt during late pregnancy through the early puerperium.

(2) Often asymptomatic, but pain occur if there is hemorrhage into the follicles or there is ovarian torsion.

(3) Ascites is rare.

(4) Occasional patients with nontrophoblastic disease may develop virilization.


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