BackgroundTo evaluate predictive factors for recovery time from severe ovarian hyperstimulation syndrome (OHSS).MethodsIn a retrospective cohort study, 201 women who were hospitalized for severe OHSS were included. Patients with recurrent OHSS were excluded. All the patients received standardized treatment including intravenous hydration, plasma volume expansion, human albumin, furosemid, subcutaneous heparin, and paracentesis if necessary. The main outcome parameter was recovery time from OHSS. Recovery was defined if a morning hematocrit <40%, rebalance of electrolytes, and serum creatinine <1 mg/dL were reached during the standardized therapy and the patient had not suffered from abdominal pain and discomfort at least for one day without any OHSS-specific infusions or medications.ResultsPregnant patients (n = 80, 39.8%) revealed a longer median duration until recovery than non-pregnant patients (n = 121, 60.2%; 10 days, IQR 7-13, vs. 8 days, IQR 6-10, respectively; p = 0.001). In a generalized linear model, presence of polycystic ovary syndrome before controlled ovarian hyperstimulation (beta = 0.3342 +/- 0.1335, p = 0.012) and use of hCG for ovulation induction (beta = 0.222 +/- 0.1389, p = 0.048) were associated with a longer recovery time in pregnant patients. In non-pregnant patients, none of the tested factors was associated with recovery time.ConclusionsPregnant patients with severe OHSS needed a significantly longer recovery time than non-pregnant patients. In pregnant patients, presence of polycystic ovary syndrome and ovulation induction with hCG were associated with longer recovery times.
Background: To identify predictors of paracentesis in women with severe ovarian hyperstimulation syndrome (OHSS). Methods: In a retrospective cohort study, we assessed patient characteristics and outcome measures of women with severe OHSS Golan grade II/III from 1996 to 2010 using univariate and multivariate analyses with the number of paracenteses as the main outcome. Results: Three hundred ninety four women with OHSS Golan grade II (n = 40) and grade III (n = 354) were included in the study. Paracentesis was performed in 108/394 (27%) of these women. One paracentesis was performed in 63 (16%), 2 paracenteses in 26 (6%), and ≥3 paracenteses 19 (5%) women, respectively. No thrombotic or cerebrovascular morbidity occurred. The mortality of the cohort was 0/394 (0%). In a univariate analysis, late onset OHSS (p = 0.02), pregnancy (p < 0.001), human chorionic gonadotropin use (p = 0.02), ovarian diameter (p = 0.006), and elevated serum levels of alanine aminotransferase (p < 0.001), hematocrit (p < 0.001), leucocytes (p < 0.001), thrombocytes (p < 0.001), and uric acid (p < 0.001) were associated with paracentesis. In a multivariate logistic regression analysis, only alanine aminotransferase (OR 1.006; 95% CI 1.001-1.01) and hematocrit (OR 1.16; 95% CI 1.05-1.27) were independently associated with paracentesis. Conclusion: Alanine aminotransferase and hematocrit at initial presentation are independent predictors of paracentesis.
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