Ovarian hyperstimulation syndrome: Difference between revisions
| Line 14: | Line 14: | ||
*[[Thromboembolism]] | *[[Thromboembolism]] | ||
**Both venous and arterial | **Both venous and arterial | ||
*Hypervolemic hyponatremia | *Hypervolemic [[hyponatremia]] | ||
*'''[[Beta-HCG]] may be positive if [[beta-HCG]] injection given as part of fertility treatment''' | *'''[[Beta-HCG]] may be positive if [[beta-HCG]] injection given as part of fertility treatment''' | ||
Revision as of 20:57, 26 March 2014
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
- Beta-HCG may be positive if beta-HCG injection given as part of fertility treatment
Differential Diagnosis
- Ectopic Pregnancy
- Molar Pregnancy
- Sepsis
- PE
Workup
- Urine pregnancy
- Pelvic ultrasound
- CBC
- Chem 10
- CXR
- Progesterone level
- Estradiol level
- PT/PTT
- Fibrinogen
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
Sources
Up to Date William's Gynecology