Ovarian hyperstimulation syndrome
Revision as of 03:28, 28 September 2015 by Rossdonaldson1 (talk | contribs)
Background
- Fertility treatments causing development of multiple follicles at once
- Fluid shifts out of vasculature
Clinical Features
- Ovarian enlargement
- Movement of fluid out of vasculature
- Ascites
- Pleural effusions
- Pericardial effusion
- Hypotension
- Electrolyte Imbalances
- DIC
- Thromboembolism
- Both venous and arterial
- Hypervolemic hyponatremia
Differential Diagnosis
- Ectopic Pregnancy
- Molar Pregnancy
- Sepsis
- PE
Diagnosis
- Urine pregnancy
- Pelvic ultrasound
- CBC
- Chem 10
- CXR
- Progesterone level
- Estradiol level
- PT/PTT
- Fibrinogen
- Beta-HCG may be positive if beta-HCG injection given as part of fertility treatment
Management
- Fluid Resuscitation
- Therapeutic paracentesis if necessary
- Self limited, resolved in 10-14 days
- Urgent GYN consultation
Disposition
- May require ICU admission for third spacing
- Admit all but most mild cases to monitored setting
See Also
References
- Up to Date
- William's Gynecology