Ovarian hyperstimulation syndrome: Difference between revisions
| Line 35: | Line 35: | ||
==Management== | ==Management== | ||
*Fluid | *[[Fluid Resuscitation]] | ||
*Therapeutic paracentesis if necessary | *Therapeutic [[paracentesis]] if necessary | ||
*Self limited, resolved in 10-14 days | *Self limited, resolved in 10-14 days | ||
*Urgent GYN consultation | *Urgent GYN consultation | ||
Revision as of 20:58, 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