Volume expanders for the prevention of ovarian hyperstimulation syndrome

Youssef, Mohamed; Mourad, Selma

doi:10.1002/14651858.cd001302.pub3

Cited by 20 publications

(13 citation statements)

References 70 publications

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“…Several strategies to prevent OHSS has been reported in the literature, including the use of low dose gonadotropins and freeze all embryos and the GnRH agonist as an oocyte trigger in GnRH antagonist cycles [10].These strategies can prevent most of the early onset OHSS, and compared with early OHSS, we pay more attention to late OHSS, because it tends to be more severe and last longer time, and patients had symptoms which maybe lethal. From the previous study, we know young age and number of oocytes retrieved are high risk factors, clinically we noticed within the same age range and oocyte number range, they all have chemical pregnancy after embryos transfer, some patients develop into OHSS and some patient are normal, what is the high risk factor?…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Outcome in Late-onset Severe OHSS Patients Following Different Ascetic Fluid Drainage and Comparison With the Non-OHSS IVF Patients

YUN

Yang

et al. 2020

Preprint

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Introduction： Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic serious complication during assisted reproductive technology, the aim of our research is to explore the differences of pregnancy outcome between severe OHSS patients and the non-OHSS IVF patients, and also compare the pregnancy outcome of different ascites drainage way of severe OHSS patients.Design: This is a retrospective cohort analysis carried out in a University-affiliated reproductive center from 2012 to 2019 ,between 359 women with severe OHSS following ascites draining and 345 non-OHSS women (matched by age and retrieved oocyte number).We examined the rates of clinical pregnancy, multiple pregnancies, miscarriage, live birth and preterm delivery between the two groups. Within the OHSS group (central venous catheter group vs paracentesis group), odds ratios (ORs) and 95% confidence intervals (CIs) of measure of clinical pregnancy were also analyzed.Result： The biochemical pregnancy loss rate of non-OHSS patients was significantly higher than that of severe OHSS patients (11.1% vs 0.6%) , the live birth, multiple pregnancy (twin pregnancy ) was much more in severe OHSS group than in control group(88.9% vs 73.5%; 57.6% vs 28.1% respectively), and there was no significant difference between singleton and twin preterm rate and neonatal birth weight between OHSS and control group. Binary logistic regression analysis revealed multiple pregnancy and long-protocol showed relatively high odds ratio, suggest that thelong-protocol of COS and multiple pregnancy are the risk factor of severe OHSS.Among severe OHSS following ascites draining, in comparison with abdominal paracentesis and central venous catheter, the ascites volume in central venous catheter group was much more than abdominal paracentesis group, there was significant difference between the two groups. There was no significant difference between the two groups in comparison of live birth, and the birth weight of singleton and twin between these two groups. but the premature birth rate of singleton in group 1 was 9.3% (10/107), whereas in group 2, it was 3.75%.Conclusion： In conclusion, this preliminary report suggests that for the IVF-ET patients, less basic follicle number, GnRH antagonist cycle, singleton maybe the protective factors for the late-onset OHSS. Paracentesis and central venous catheter are all the effective modality to manage the ascites for the severe OHSS patients. For the patients who have the possibility of repeated paracentesis, catheter is a safe and effective way.

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Section: Discussionmentioning

confidence: 99%

Pregnancy Outcome in Late-onset Severe OHSS Patients Following Different Ascetic Fluid Drainage and Comparison With the Non-OHSS IVF Patients

YUN

Yang

et al. 2020

Preprint

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“…Последствиями этого патологического процесса являются гиповолемия и гемоконцентрация, большие потери белка, формирование полисерозитов, нарушение почечной перфузии, олигурия, нарушение функции печени, развитие абдоминальной гипертензии, развитие острой дыхательной недостаточности, тромбоэмболические осложнения [12,13]. Гиповолемию усугубляют рвота и нарушение энтерального приема жидкости и пищи.…”

Section: этиология и патогенезunclassified

“…Следует помнить, что инфузионная терапия не сможет полностью устранить все проявления СГЯ, а призвана только корригировать наиболее тяжелые последствия нарушения проницаемости сосудов [12,13].…”

Section: рекомендация 3 синтетические коллоиды при сгя использоватьсunclassified

Intensive treatment of ovarian hyperstimulation syndrome. Clinical guidelines (treatment protocol)

Adamyan

Артымук

Belokrinitskaya

et al. 2018

Annals of Critical Care

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Синдром гиперстимуляции яичников (СГЯ) -системное заболевание, развивающееся в результате активации продукции вазоактивных медиаторов яичниками на фоне стимуляции суперовуляции. СГЯ характеризуется повышением проницаемости стенки капилляров, что приводит к выходу внутрисосудистой жидкости во внесосудистое пространство, ее накоплению в третьем пространстве и гемоконцентрации. Тяжелая степень СГЯ характеризуется риском развития тромбозов, нарушением функции печени, почек и возникновением респираторного дистресс-синдрома взрослых (РДСВ). В настоящих клинических рекомендациях представлены основные положения по прогнозу, диагностике, профилактике и интенсивной терапии СГЯ, включающие принципы лечения синдрома внутрибрюшной гипертензии (ВБГ).• Ключевые слова: синдром гиперстимуляции яичников, интенсивная терапия, профилактика СГЯ Для корреспонденции: Маршалов Дмитрий Васильевич -д-р мед. наук, доцент кафедры симуляционных технологий и неотложной медицины ФГБОУ ВО «Саратовский государственный медицинский университет им. В.И. Разумовского» Минздрава России,

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“…• Reposición hídrica con expansores de volumen, preferiblemente soluciones cristaloides al medio para mantener una diuresis media de entre 30 y 50ml/h (15,16). • Evaluar la necesidad de realizar paracentesis evacuadoras por técnica convencional o guiada por ultrasonografía (ajustar la reposición hídrica con cristaloides o coloides de elección teniendo en cuenta si hay indicación).…”

Section: Tratamientounclassified

Síndrome de hiperestimulación ovárica severo: Informe de caso y revisión de literatura

Contreras¹,

Echeverry²,

Duarte

et al. 2017

MedUNAB

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Introducción: El síndrome de hiperestimulación ovárica severo es la complicación más grave de la estimulación ovárica durante la inducción de la ovulación. Los hallazgos característicos son la presencia de ovarios aumentados de volumen y ascitis en relación a extravasación de líquido por aumento de la permeabilidad capilar, cuya severidad puede llevar a falla respiratoria, renal, colapso hemodinámico y eventos tromboembólicos. Objetivo: Describir un caso clínico de síndrome de hiperestimulación ovárica, junto con una revisión de la literatura sobre la patología, orientada al diagnóstico y tratamiento óptimo de pacientes con estas características clínicas. Presentación del caso: Paciente de 29 años con antecedente de síndrome de ovario poliquístico que presenta síndrome de hiperestimulación ovárica severo como complicación secundaria a estimulación gonadotrófica. El cuadro clínico mostró ovarios aumentados de tamaño en la evaluación sonográfica; anasarca dada por ascitis y derrames pleurales bilaterales e insuficiencia respiratoria tipo distrés respiratorio del adulto. Se realizó paracentesis y se utilizó ventilación mecánica no invasiva, logrando la expansión pulmonar. Discusión: El análisis de este caso se inició siete días después de la administración de gonadotropina, favorecido por las condiciones previas de la paciente, sin complicaciones letales. Conclusiones: La paracentesis puede constituir una opción terapéutica efectiva en el tratamiento de ascitis con compromiso de la función pulmonar. La ventilación mecánica no invasiva es una estrategia para evitar la intubación en estas pacientes lo cual evita los periodos de sedación exhaustivos y el consiguiente riesgo de broncoaspiración. [Urbina-Contreras ZE, Urbina-Echeverry SE, Lamos-Duarte AF, Picón-Jaimes YA. Síndrome de hiperestimulación ovárica severo: Informe de caso y revisión de literatura. MedUNAB 2017; 20(2): 244-251].

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Volume expanders for the prevention of ovarian hyperstimulation syndrome

Cited by 20 publications

References 70 publications

Pregnancy Outcome in Late-onset Severe OHSS Patients Following Different Ascetic Fluid Drainage and Comparison With the Non-OHSS IVF Patients

Pregnancy Outcome in Late-onset Severe OHSS Patients Following Different Ascetic Fluid Drainage and Comparison With the Non-OHSS IVF Patients

Intensive treatment of ovarian hyperstimulation syndrome. Clinical guidelines (treatment protocol)

Síndrome de hiperestimulación ovárica severo: Informe de caso y revisión de literatura

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