Marshalov D V, Salov I A, Shifman E M, Petrenko A P, Saliukov R R, Batsunova M O
Anesteziol Reanimatol. 2013 Nov-Dec(6):41-6.
To evaluate the role of intraabdominal hypertension in the development and outcome of ovarian hyperstimulation syndrome.
60 patients with varying degrees of ovarian hyperstimulation syndrome (OHSS) due to ongoing pregnancy were involved in the study. Intraabdominal pressure (IAP) was measured in the bladder. Performance of abdominal perfusion pressure, filtration gradient, extensibility and compliance of the anterior abdominal wall were evaluated. A size of the ovaries, chorionic condition and ascites were determined by ultrasonic method. Relation of pregnancy outcome and IAP was analyzed.
The mean value of IAP in patients with light form of ovarian hyperstimulation syndrome was 7.05 +/- 1.76 mm Hg, 13.65 +/- 1.92 mm Hg in patients with moderate form, and 20.60 +/- 2.52 mm Hg in patients with severe form of OHSS. The leading factors in the development and progression of intraabdominal hypertension (IAH) are the volume of the ovaries, ascites, and extensibility of the abdominal wall. The comparison of pregnancy outcome and severity of IAP revealed a strong positive correlation--r = 0.726, p < 0.001.
Evaluation of the severity of intra-abdominal hypertension in patients with ovarian hyperstimulation syndrome with considering the clinical data and results of laboratory and instrumental studies allow clarifying the severity of condition and predict the potential complications and pregnancy outcomes.
评估腹腔高压在卵巢过度刺激综合征发生发展及预后中的作用。
本研究纳入60例因持续妊娠而患有不同程度卵巢过度刺激综合征(OHSS)的患者。于膀胱内测量腹腔内压力(IAP)。评估腹部灌注压、滤过梯度、前腹壁的伸展性和顺应性。通过超声方法确定卵巢大小、绒毛膜情况及腹水情况。分析妊娠结局与IAP的关系。
轻度卵巢过度刺激综合征患者的IAP平均值为7.05±1.76 mmHg,中度患者为13.65±1.92 mmHg,重度OHSS患者为20.60±2.52 mmHg。腹腔高压(IAH)发生发展的主要因素为卵巢体积、腹水及腹壁伸展性。妊娠结局与IAP严重程度的比较显示出强正相关——r = 0.726,p < 0.001。
结合临床数据以及实验室和器械检查结果评估卵巢过度刺激综合征患者腹腔高压的严重程度,有助于明确病情严重程度,并预测潜在并发症及妊娠结局。