Gebril Amr, Hamoda Haitham, Mathur Raj
a Department of Obstetrics and Gynaecology, Faculty of Medicine , Cairo University , Cairo , Egypt.
b King's College Hospital NHS Foundation Trust , London , UK.
Hum Fertil (Camb). 2018 Jun;21(2):98-105. doi: 10.1080/14647273.2017.1331048. Epub 2017 May 29.
Ovarian hyperstimulation syndrome (OHSS) is a potentially serious complication of assisted reproductive treatment. Management of women with severe OHSS has traditionally included hospitalisation for close monitoring and supportive treatment. The aim of this review is to assess the evidence for safety and efficacy of outpatient management of severe OHSS. A systematic review of studies describing outpatient management options was performed. Current guidance from advisory bodies was also reviewed. Outpatient management has been found in observational studies to be safe and cost-effective compared to inpatient management. Paracentesis of ascitic fluid seems to be effective treatment for severe OHSS along with supportive management including maintenance of fluid balance and preventative measures against thrombo-embolism. GnRH antagonist was shown in few studies to be effective in treatment of early severe OHSS although further research is required to assess its role in this context. Appropriate outpatient set up and protocols are essential to provide safe outpatient management for women with severe OHSS.
卵巢过度刺激综合征（OHSS）是辅助生殖治疗中一种潜在的严重并发症。传统上，对重度OHSS患者的管理包括住院进行密切监测和支持治疗。本综述的目的是评估重度OHSS门诊管理安全性和有效性的证据。对描述门诊管理方案的研究进行了系统综述。还查阅了咨询机构的现行指南。观察性研究发现，与住院管理相比，门诊管理是安全且具有成本效益的。腹腔穿刺放腹水似乎是重度OHSS的有效治疗方法，同时还包括维持液体平衡和预防血栓栓塞等支持性管理措施。少数研究表明，GnRH拮抗剂在治疗早期重度OHSS方面有效，不过还需要进一步研究来评估其在这种情况下的作用。适当的门诊设置和方案对于为重度OHSS患者提供安全的门诊管理至关重要。
