Ovarian hyperstimulation syndrome (OHSS): diagnosis and management |
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Authors: | P Myrianthefs C Ladakis V Lappas S Pactitis A Carouzou G Fildisis G Baltopoulos |
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Institution: | (1) Athens University School of Nursing ICU, “Agioi Anargyroi” Cancer Hospital of Kifissia, Nea Kifissia 14564, Greece e-mail: pavlosm@mfa.gr Tel.: + 30-1-7 79 16 35,, GR;(2) Fax: + 30-1-7 79 16 35,;(3) “IASO” Maternity Hospital ICU, Marousi 15123, Athens, Greece, GR |
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Abstract: | Objective: To present our experience and the current knowledge about pathophysiology, diagnosis, and management of the ovarian hyperstimulation
syndrome (OHSS). Design: Retrospective study concerning clinical and laboratory findings of severe OHSS. Setting: General ICU at a maternity-surgical hospital. Patients: Ten patients suffering from severe OHSS. Interventions: Supportive and preventive therapeutic measures applied are described. Measurements and results: Admission and discharge data as well as worst values during disease course were recorded. Clinical and laboratory findings
showed third space fluid shift leading to weight gain, generalized tissue edema, ascites, hydrothorax, abdominal distension
and pain, chest discomfort, hypovolemia, dehydration, ovaries enlargement, electrolyte disturbances, hypoalbuminemia, high
hematocrit, urea, and WBC. Conclusions: OHSS is an iatrogenic complication of assisted conception of unknown pathogenesis, with potentially life-threatening sequelae
due to hemoconcentration such as circulatory shock, ARDS, hepato-renal failure, thromboembolic phenomena, and multi-organ
dysfunction syndrome. Gynecologists and intensivists must be aware of the diagnosis and management of the syndrome because
of the widely used reproductive techniques for assisted conception.
Received: 8 July 1999 Final revision received: 3 January 2000 Accepted: 15 February 2000 |
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Keywords: | Assisted conception Capillary permeability Intensive care Ovarian hyperstimulation syndrome (OHSS) Ovulation induction Third space fluid shift |
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