Ovarian hyperstimulation syndrome (OHSS): diagnosis and management

Objective: To present our experience and the current knowledge about pathop hysiology, diagnosis, and management of the ovarian hyperstimulation syndro me (OHSS). Design: Retrospective study concerning clinical and laboratory findings of severe OHSS. Setting: General ICU at a maternity-surgical hospital. Patients: Ten patients suffering from severe OHSS. Interventions: Supportive and preventive therapeutic measures applied are d escribed. Measurements and results: Admission and discharge data as well as worst val ues during disease course were recorded. Clinical and laboratory findings s howed third space fluid shift leading to weight gain, generalized tissue ed ema, ascites, hydrothorax, abdominal distension and pain, chest discomfort, hypovolemia, dehydration, ovaries enlargement, electrolyte disturbances, h ypoalbuminemia, high hematocrit, urea, and WBC. Conclusions: OHSS is an iatrogenic complication of assisted conception of u nknown pathogenesis, with potentially life-threatening sequelae due to hemo concentration such as circulatory shock, ARDS, hepatorenal failure, thrombo embolic phenomena, and multi-organ dysfunction syndrome. Gynecologists and intensivists must be aware of the diagnosis and management of the syndrome because of the widely used reproductive techniques for assisted conception.