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Acute oligo-anuria during ovarian hyperstimulation syndrome
H E Demey1, R Daelemans, D Galdermans
1Department of Intensive Care, University of Antwerp UIA, University Hospital Antwerp, Belgium.
Acta Obstetricia Et Gynecologica Scandinavica
|January 1, 1987
Summary
Severe ovarian hyperstimulation syndrome (OHSS) occurred during ovulation induction. Treatment complications included acute kidney injury and pulmonary edema, possibly linked to indomethacin and fluid therapy.
Area of Science:
- Reproductive Endocrinology
- Nephrology
- Critical Care Medicine
Background:
- Ovulation induction therapy using human menopausal gonadotropins (hMG) and human chorionic gonadotropin (hCG) is a standard treatment for infertility.
- Severe ovarian hyperstimulation syndrome (OHSS) is a rare but serious complication of such treatments.
- Understanding OHSS pathogenesis is crucial for patient management.
Observation:
- A young woman developed severe OHSS during ovulation induction.
- The condition was complicated by acute functional renal insufficiency.
- Signs of vascular overfilling and incipient pulmonary edema were noted.
Findings:
- The patient's renal insufficiency and edema may have been exacerbated by indomethacin and aggressive fluid resuscitation.
- Pathogenetic mechanisms linking gonadotropin therapy, OHSS, and subsequent complications were investigated.
- The interplay between systemic inflammation, capillary leak, and fluid balance in severe OHSS was explored.
Implications:
- This case highlights the importance of vigilant monitoring during ovulation induction, especially in patients at risk for OHSS.
- Careful consideration of concomitant medications, such as NSAIDs like indomethacin, is warranted in OHSS management.
- Further research into the precise mechanisms of OHSS-related renal and pulmonary complications could lead to improved treatment protocols.