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[The ovarian hyperstimulation syndrome. Anesthesiologic aspects based on a severe case]
I Heylen1, I Pichlmayr, H W Schlösser
1Zentrum für Anaesthesiologie, Abteilung IV, Hochschule Hannover.
Der Anaesthesist
|June 1, 1990
Summary
Ovarian hyperstimulation syndrome (OHS) is a serious complication of ovulation induction, ranging from mild to life-threatening. Early monitoring and prompt treatment are crucial for managing OHS and preventing severe outcomes.
Area of Science:
- Reproductive endocrinology and infertility.
- Clinical management of iatrogenic complications.
Background:
- Ovarian hyperstimulation syndrome (OHS) is an iatrogenic complication associated with ovulation induction therapies.
- OHS presents with a spectrum of clinical and laboratory findings, categorized into mild, moderate, and severe forms.
Observation:
- Severe OHS involves massive ovarian enlargement, hemoconcentration, and third-space fluid accumulation (ascites, pleural/pericardial effusions).
- Potential complications of severe OHS include renal failure, hypovolemic shock, thromboembolism, ARDS, and mortality.
Findings:
- Pathophysiological mechanisms underlying OHS remain largely unknown.
- Monitoring plasma estradiol and ultrasonographic follicle evaluation can help reduce OHS incidence.
Implications:
- Anesthesiological considerations for OHS management are discussed.
- A treatment strategy involving serial ultrasonography, clinical/biochemical assessment, fluid resuscitation, and procedural interventions is proposed.