Jakimiuk Artur J, Fritz Anna, Grzybowski Wojciech, Walecka Irena, Lewandowski Piotr
Department of Obstetrics and Gynecology in Central Clinical Hospital of Ministry of Interior and Administration, Warsaw, Poland.
Folia Histochem Cytobiol. 2007;45 Suppl 1:S105-8.
Severe ovarian hyperstymulation syndrome is a rare but potentially life-threatening complication in patients undergoing assisted reproductive techniques (ART). The pathogenesis of this condition is likely to be multifactorial. The aim of the retrospective study was to present management in moderate and severe iatrogenic ovarian hyperstymulation syndrome (OHSS) in clinical material. The study group was 19 women, admitted to the Department of Obstetrics and Gynecology in Central Clinical Hospital of Ministry of Interior and Administration in Warsaw from large outpatient infertility center "Novum" in Warsaw with moderate and severe OHSS between 14.07.2004 and 8.11.2005. Laboratory tests and ultrasound examination of the ovarian size and ascites were performed, abdominal circumference was measured. Patients were treated with rehydration with intravenous crystalloids and colloids, diuretics, antibiotics, anticoagulants and ultrasound-guided paracentesis if symptoms of ascites become severe (ascites causes pain and compromised pulmonary function). Oral intake of water was restricted, monitoring of fluid intake and output, and daily monitoring of body weight was performed. During treatment controlled laboratory tests were done. In one patient occurred intra-abdominal hemorrhage from ovarian rupture and laparotomy with oophorectomy was performed. The ovarian hyperstimulation syndrome is still a difficult diagnostic and therapeutic problem and more studies are required to elucidate pathophysiology of OHSS. Because of still unknown etiology treatment is empirical and in most of cases bases on experience of medical team. Thus, the management in individual patients varies according to the severity of ovarian hyperstymulation syndrome and its complications.
严重卵巢过度刺激综合征是接受辅助生殖技术（ART）患者中一种罕见但可能危及生命的并发症。这种情况的发病机制可能是多因素的。这项回顾性研究的目的是介绍临床资料中中度和重度医源性卵巢过度刺激综合征（OHSS）的管理情况。研究组为19名女性，她们于2004年7月14日至2005年11月8日期间，因中度和重度OHSS从华沙大型门诊不孕不育中心“Novum”被收治到华沙内政和行政部中央临床医院妇产科。进行了实验室检查、卵巢大小及腹水的超声检查，并测量了腹围。患者接受静脉晶体液和胶体液补液、利尿剂、抗生素、抗凝剂治疗，若腹水症状严重（腹水引起疼痛并损害肺功能）则进行超声引导下腹腔穿刺放液。限制口服水分摄入，监测液体出入量，并每日监测体重。治疗期间进行了实验室检查。1例患者发生卵巢破裂导致腹腔内出血，遂行剖腹手术及卵巢切除术。卵巢过度刺激综合征仍然是一个诊断和治疗难题，需要更多研究来阐明OHSS的病理生理学。由于病因仍不明，治疗是经验性的，大多数情况下基于医疗团队的经验。因此，根据卵巢过度刺激综合征的严重程度及其并发症，个体患者的管理方式有所不同。
