Spontaneous Ovarian Hyperstimulation Syndrome: A Report of Two Cases from Different Pathogenesis.

Spontaneous ovarian hyperstimulation syndrome (s-OHSS) is a rare finding that occurs in early pregnancy. There is a rapidly increasing ovarian size secreting vasoactive substances that lead to fluid shift into third spaces. This occurs in the absence of exogenous hormonal therapy. We present two cases of s-OHSS. A 35-year-old gravida 4 para 3 presented with complaints of progressive abdominal pain, distension, nausea, vomiting, and difficulty in breathing at 10 weeks gestation. On imaging, a singleton intrauterine gestation, enlarged ovaries containing multiple cysts, and moderate ascites were seen. Second, a 17-year-old primigravida presented with abdominal distension and pain and bleeding per vaginam following 4 months amenorrhea. A bulky uterus containing a large hyperechoic structure with multiple cystic spaces in keeping complete molar gestation and enlarged ovaries containing multiple cysts were seen on ultrasound imaging. The singleton gestation was managed successfully to term with conservative therapy tailored to clinical symptoms.

The prevalence and determinants of HIV seroconversion among booked ante natal clients in the University of Uyo teaching hospital, Uyo Akwa Ibom State, Nigeria.

INTRODUCTION: The Prevention of Mother to Child transmission (PMTCT) of HIV, an important intervention in the fight against HIV/AIDS can only be of benefit if the HIV status of the mother is known. Unfortunately, some women receive HIV counseling and testing (HCT) during the window period or prior to new infection in pregnancy and therefore, miss-out on the gains of PMTCT. A repeat HIV test would identify this later seroconversion and ensure early intervention. This study aimed at determining the prevalence of HIV seroconversion during pregnancy and assessing the factors associated with HIV seroconversion in clients who attended ante-natal clinic (ANC) in University of Uyo Teaching Hospital, Uyo. METHODS: A descriptive cross-sectional design was used to study 502 HIV negative clients who consecutively presented for ANC in the University of Uyo Teaching Hospital Uyo over a 3 months period (July -September 2013). RESULTS: Fifteen (3%) of the 502 women who were HIV negative at booking visit tested positive (seroconverted) to HIV. Determinants of seroconversion at multivariate level were age bracket of 25-29 years (OR: 3.20; 95%CI: 2.39-4.29) clients' partners who had sexually transmitted infections, as evidenced by penile discharge (OR: 0.09; 95%CI: 0.01-0.45); Clients in polygamous setting (OR: 3.98; CI: 1.64-9.65); those taking alcohol (OR: 0.12; CI: 0.20-0.80) and those with partners taking recreational drugs (OR: 0.05, 95%CI: 0.002-0.995). CONCLUSION: The study revealed a high seroconversion rate. Re-screening of pregnant women after the booking HCT is a very cost effective and beneficial strategy for the elimination of mother to child transmission of HIV.