Ovarian hyperstimulation syndrome

Revision as of 00:45, 26 March 2014 by Alinker (talk | contribs) (new note)

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

Differential Diagnosis

  • Ectopic pregnancy

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

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