Ovarian hyperstimulation syndrome. A new look at an old problem

Abstract

To analyze the management of severe ovarian hyperstimulation syndrome based on aspects of its etiology and pathogenesis a systematic review of the literature was done. An evaluation of clinical trials, meta-analysis, case-reports and reviews assessing the management of different conditions related to ovarian hyperstimulation syndrome was made using the following data sources: MEDLINE Pubmed (from 1966 to July 2018) and the Cochrane Controlled Clinical Trials Register, Embase (up to July 2018). The role of intra-abdominal hypertension in the development of the severe forms of ovarian hyperstimulation syndrome and its complicated outcomes was assessed. The pathophysiology and clinic of intra-abdominal hypertension syndrome are almost identical to moderate and severe forms of ovarian hyperstimulation syndrome and associated organ dysfunction. The classic triad (respiratory disorders, reduction in venous return, and restriction of perfusion in internal organs) is present in severe ovarian hyperstimulation syndrome as well as in intra-abdominal hypertension syndrome. This review provides recommendations for the management of ovarian hyperstimulation syndrome and insight into the different medical complaints of this syndrome. The principles of therapy for intra-abdominal hypertension syndrome might be considered in the treatment of severe forms of ovarian hyperstimulation syndrome.

摘要

从卵巢过度刺激综合征的病因及其发病机理角度分析其治疗方法进行了系统的综述。临床试验, 荟萃分析、病例报告和综述对卵巢过度刺激不同情况下的管理方案进行检索, 检索文献的来源为：Pubmed（1966年到2018年7月）, Cochrane及临床实验注册中心, Embase（截止到2018年7月）。腹腔内高压对于发展为重度卵巢过度刺激综合征的作用, 及其复杂结局进行评估。腹腔高压综合征的病理生理改变及其临床表现几乎等同于中中重度的卵巢过度刺激综合征, 而且与器官功能衰竭有关。典型的三联征（呼吸紊乱, 静脉回流减少, 器官灌注减少）会在重度卵巢过度刺激综合征中出现。本文中对于卵巢过度刺激综合征及其不同并发症的管理方法及观点。腹腔内高压的治疗原则可能需要考虑重度卵巢过度刺激综合征的治疗。

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
• complications
• intra-abdominal pressure
• abdominal hypertension syndrome

Disclosure statement

The authors declare no conflict of interest.