[Treatment and prevention of the ovarian hyperstimulation syndrome]

Frequency and features of ovarian hyperstimulation syndrome (OHS) were reviewed in 41 women stimulated with human menopausal gonadotropin (HMG) during 130 cycles. There were 7 cases of OHS, since 17% of patients and 5.3% of cycles were affected; 3 cases were mild, 2 moderate and 2 severe. Of these 41 women, 21 pregnancies occurred (51%) and 19 newborns were healthy. The patients with OHS received 1060 +/- 235 (X +/- DE) UI of HMG and there was not a significative difference with the amount of HMG units in remaining subjects. Symptoms began 3-6 days after human chorionic gonadotropin (HCG) administration. Women with mild OHS were treated as out patients with bed rest and 100 mg indomethacin in suppositories two times a day. Moderate and severe OHS were hospitalized with bed rest; careful monitoring of fluid intake and output, weight and abdominal perimeter daily, as well as vital signs were withdrawn. Patients with severe OHS were treated in the intensive care unit for detection and management of complications. One patient was submitted to laparotomy because of a probably ovarian rupture, but it was discarded in the surgery. OHS remained between 6 and 8 days. Patients with OHS presented 3 pregnancies, 2 were twins and the other was ectopic. Emphasis was made in the prophylactic measures to avoid the OHS.