Clinic Institute of Gynecology, Obstetrics and Neonatology-Hospital Clinic Barcelona, Faculty of Medicine-University of Barcelona, Institut d ´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Department of Emergency Anesthesiology-Resuscitation Care and Simulation Technologies in Medicine, Saratov State Medical University named after V. I. Razumovsky, Saratov, Russian Federation.
Reprod Sci. 2021 Apr;28(4):1041-1048. doi: 10.1007/s43032-020-00339-8. Epub 2020 Oct 15.
The present study aims to assess the usefulness of severity markers in women with ovarian hyperstimulation syndrome (OHSS). An observational study was designed including 76 women with varying degrees of severity of OHSS. Clinical history, physical examination, laboratory tests, and ultrasound measurement of the ovarian size and ascites index were carried out in all patients. Intra-abdominal pressure (IAP) was measured using an intravesical Foley Manometer catheter. Ascites index and ovarian volume increased progressively being highest in the most severe stage of OHSS. The median IAP in mild OHSS was found to be lower than that in the moderate and severe OHSS (4.0 mm, 12 mm, and 16.0 mm, respectively). Critical cases of OHSS presented the highest IAP (25.0 mm). IAP did not reach the level of intra-abdominal hypertension in mild OHSS, whereas moderate and severe OHSS was associated with intra-abdominal hypertension grade I and grade II-III, respectively. Values of IAP in critical OHSS were found similar to those observed in abdominal compartment syndrome patients. The IAP showed a strong positive correlation with ovarian volume and ascites index. The reduction of IAP after paracentesis was greater among critical OHSS patients. The ovarian volume and the level of intra-abdominal hypertension are related to the severity of OHSS and are of particular importance in the initialization of the syndrome. Ascites index is simple and convenient and can serve as an indirect marker of the abdominal reserve volume. In conjunction with clinical and laboratory data, ascites index and IAP values might be indicators for paracentesis.
本研究旨在评估卵巢过度刺激综合征（OHSS）患者严重程度标志物的有用性。设计了一项观察性研究，纳入了 76 名不同严重程度 OHSS 的女性患者。所有患者均进行了临床病史、体格检查、实验室检查以及卵巢大小和腹水指数的超声测量。使用膀胱内 Foley 测压计导管测量腹腔内压（IAP）。腹水指数和卵巢体积逐渐增加，在 OHSS 最严重阶段最高。轻度 OHSS 患者的中位 IAP 低于中度和重度 OHSS（分别为 4.0 mm、12 mm 和 16.0 mm）。严重 OHSS 的危急病例的 IAP 最高（25.0 mm）。轻度 OHSS 时 IAP 未达到腹腔内高压水平，而中重度 OHSS 分别与腹腔内高压 I 级和 II-III 级相关。严重 OHSS 患者的 IAP 值与观察到的腹腔间隔室综合征患者相似。IAP 与卵巢体积和腹水指数呈强正相关。在危急 OHSS 患者中，腹水抽吸后 IAP 降低幅度更大。IAP 和卵巢体积与 OHSS 的严重程度相关，在综合征的初始阶段尤为重要。腹水指数简单方便，可以作为腹部储备容量的间接标志物。结合临床和实验室数据，腹水指数和 IAP 值可能是进行腹水抽吸的指标。
