Alternative strategies for the management of ovarian hyperstimulation syndrome, the role of intra-abdominal hypertension control

Abstract

The aim of this study is to analyze the methods for reducing intra-abdominal pressure (IAP) in the management of the moderate and severe forms of ovarian hyperstimulation syndrome (OHSS). We carried out a systematic review of the literature. An evaluation of clinical trials, meta-analysis, case-reports, and reviews assessing the management of conditions associated with OHSS and intra-abdominal hypertension (IAH)/abdominal compartment syndrome (ACS) was made using the following data sources: MEDLINE Pubmed (from 1966 to July 2019) and the Cochrane Controlled Clinical Trials Register, Embase (up to July 2019). The principles of treatment of IAH syndrome can be considered in the treatment of moderate and severe forms of OHSS. Medical treatment of patients with increased IAP in OHSS should be started early to prevent further organ dysfunction and avoid a transition to a more severe stage of IAH and ACS. Some of the new, non-surgical methods, such as continuous negative extra-abdominal pressure, are a promising option in specific groups of patients with OHSS. This review provides suggestions for the management of OHSS based on the principles of therapy for IAH syndrome. Further well-designed studies are needed to confirm these initial data.

摘要

这项研究分析了对于中重度卵巢过度刺激综合征（OHSS）患者管理中应用减少腹内压（IAP）的方法。我们对文献进行了系统的回顾。使用以下数据库分析了临床试验, 荟萃分析, 病例报告, 以及OHSS和腹腔内高压（IAH）/腹腔间隔室综合征（ACS）相关的疾病的管理的评估：MEDLINE Pubmed (1966年到2019年7月)和cochrane对照试验注册中心 (至2019年7月)。IAH综合征的治疗原则可以考虑应用于中重度卵巢过度刺激综合征（OHSS）的治疗中。对于伴有IAP增高的OHSS患者应尽早开始治疗以避免进一步发生器官衰竭以及发展为更严重的IAH和ACS。一些新的非手术方法例如持续的腹外负压, 对于特定的OHSS的患者很好的选择。这篇综述根据IAH综合征的治疗原则为OHSS的治疗提供了建议, 还需要进一步完善设计的研究来确认这些初始数据。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Ovarian hyperstimulation syndrome
• intra-abdominal pressure
• intra-abdominal abdominal hypertension syndrome
• non-surgical management
• continuous negative extra-abdominal pressure

Disclosure statement

The authors declare no conflict of interest.