To the Editor.–Causes of abdominal distention in late pregnancy include polyhydramnios, intestinal obstruction, and ascites. Although more commonly associated with hydatidiform mole and multiple gestation, massive thecal-lutein cysts (hyperreactio luteinalis) occasionally complicate normal pregnancy. I studied a case that demonstrates hyperreactio luteinalis as a cause of abdominal distention in an otherwise normal pregnancy.
Report of a Case.–A 20-year-old woman, gravida 3, para 2, complained of abdominal discomfort and dyspnea. Last normal menstruation had occurred 40 weeks earlier. The abdomen was massively distended; uterus measured 47 cm above the symphysis pubis. Bowel sounds and fetal heart tones were normal. There was no fluid wave. Ultrasonography demonstrated a single fetus in cephalic presentation (biparietal diameter, 10 cm). There was no polyhydramnios. The entire abdomen reflected multiple, round, transsonic echoes. Chest roentgenogram was normal except for elevated diaphragm and poorly aerated lung bases.
Induction of labor resulted in the uncomplicated delivery