Center for Reproductive Medicine, Henan Key Laboratory of Reproduction and Genetics, Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Obstetrics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Front Endocrinol (Lausanne). 2022 Jun 15;13:870008. doi: 10.3389/fendo.2022.870008. eCollection 2022.
This study aimed to evaluate potential predictors for recovery time in pregnant patients with moderate to severe ovarian hyperstimulation syndrome (OHSS).
A total of 424 pregnant patients with moderate to severe OHSS who underwent fertilization (IVF)/intracytoplasmic sperm injection (ICSI) were retrospectively identified. The clinical features and laboratory findings within 24 h after admission were collected. Treatment for OHSS was carried out according to standard procedures, including fluid replacement therapy, human albumin, aspirin, low-molecular-weight heparin, and paracentesis, when necessary. Patients were discharged from the hospital when the tmorning hematocrit was <40% and no obvious clinically relevant symptoms existed, such as abdominal distension, abdominal pain, and shortness of breath. Meanwhile, ultrasound indicating little pleural or abdominal effusion and biochemical abnormalities returning to normal were required. Spearman's correlation analysis was used to assess the association between the blood-related parameters and recovery time. Multiple linear regression models were used to assess the relationship between the clinical or laboratory parameters and recovery time.
The median recovery time of these patients was 11 days. In Spearman's correlation test, leukocytes, hemoglobin, platelets, hematocrit, creatinine, prothrombin time (PT), fibrinogen (Fib), D-dimer, and fibrinogen degradation products (FDPs) were positively correlated with recovery time. On the other hand, albumin and thrombin time (TT) were negatively correlated with recovery time. Multiple linear regression analysis showed that polycystic ovary syndrome (PCOS), hemoglobin, platelets, albumin, and Fib were significantly associated with the recovery time of patients with OHSS ( = 0.023, < 0.001, = 0.007, < 0.001, and = 0.019, respectively).
In pregnant patients with OHSS, PCOS and hypoalbuminemia were associated with a significantly longer recovery time. Meanwhile, the recovery time was longer when patients have high levels of hemoglobin, platelets, and Fib.
本研究旨在评估中重度卵巢过度刺激综合征（OHSS）孕妇恢复时间的潜在预测因素。
回顾性分析了 424 例中重度 OHSS 接受体外受精（IVF）/卵胞浆内单精子注射（ICSI）的妊娠患者。收集入院后 24 小时内的临床特征和实验室检查结果。根据标准程序对 OHSS 进行治疗，包括补液治疗、人血白蛋白、阿司匹林、低分子肝素和必要时行腹腔穿刺术。当清晨血细胞比容<40%且无明显临床相关症状（如腹胀、腹痛和呼吸困难）时，患者即可出院。同时，需要超声显示少量胸腔或腹腔积液以及生化异常恢复正常。采用 Spearman 相关分析评估血液相关参数与恢复时间的相关性。采用多元线性回归模型评估临床或实验室参数与恢复时间的关系。
这些患者的中位恢复时间为 11 天。在 Spearman 相关检验中，白细胞、血红蛋白、血小板、血细胞比容、肌酐、凝血酶原时间（PT）、纤维蛋白原（Fib）、D-二聚体和纤维蛋白降解产物（FDPs）与恢复时间呈正相关。另一方面，白蛋白和凝血酶时间（TT）与恢复时间呈负相关。多元线性回归分析显示，多囊卵巢综合征（PCOS）、血红蛋白、血小板、白蛋白和 Fib 与 OHSS 患者的恢复时间显著相关（β=0.023，<0.001，β=0.007，<0.001，β=0.019，分别）。
在 OHSS 妊娠患者中，PCOS 和低白蛋白血症与恢复时间显著延长相关。同时，血红蛋白、血小板和 Fib 水平升高时，恢复时间延长。
