To report a case of severe ovarian hyperstimulation syndrome (OHSS) persisting into the late second trimester of a singleton pregnancy.Case report.Academic tertiary care center.A 29-year-old woman with severe OHSS after fresh embryo transfer after controlled ovarian hyperstimulation requiring intervention until 21 weeks' gestation in a singleton pregnancy.Thorough evaluation of an unusual case of severe OHSS and medical/procedural management of its sequelae in the setting of ongoing pregnancy.The clinical development of severe OHSS during pregnancy and its effect on pregnancy outcomes.Severe OHSS persisted until 21 weeks' gestation with reaccumulating ascitic fluid, which impacted pregnancy outcomes.Clinicians should be aware of the risk of severe OHSS and its possible effect on pregnancy outcomes beyond the first trimester.
Abstract We sought to determine whether black–white gap in mortality exists among hospitalized HIV-positive patients in the United States (US). We hypothesized that in-hospital mortality (IHM) would be similar between black and white HIV-positive patients due to the nationwide availability of HIV services. Our analysis was restricted to hospitalized HIV-positive patients (15–49 years). We used the National Inpatient Sample (NIS) that covered the period from January 1, 2002 to December 31, 2014. We employed joinpoint regression to construct temporal trends in IHM overall and within subgroups over the study period. We applied multivariable survey logistic regression to generate adjusted odds ratios (OR) and 95% confidence intervals (CI). The total number of HIV-related hospitalizations and IHM decreased over time, with 6914 (3.9%) HIV-related in-hospital deaths in 2002 versus 2070 HIV-related in-hospital deaths (1.9%) in 2014, (relative reduction: 51.2%). HIV-related IHM among blacks declined at a slightly faster rate than in the general population (by 56.8%, from 4.4% to 1.9%). Among whites, the drop was similar to that of the general population (51.2%, from 3.9% to 1.9%). Although IHM rates did not differ between blacks and whites, being black with HIV was independently associated with a 17% elevated odds for IHM (OR = 1.17; 95% CI = 1.11–1.25). In-hospital HIV-related deaths continue to decline among both blacks and whites in the US. Among hospitalized HIV-positive patients black–white disparity still persists, but to a lesser extent than in the general HIV population. Improved access to HIV care is a key to eliminating black–white disparity in HIV-related mortality.
