| The pathophysiology of ovarian hyperstimulation syndrome: an unrecognized compartment syndrome. | |
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MedLine Citation:
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PMID: 19836016 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To compare and contrast the pathophysiology of ovarian hyperstimualtion syndrome (OHSS) with known syndromes of increased intraabdominal pressure (IAP), and to explore the relationship of increased IAP with symptom severity in OHSS. DESIGN: Literature review. MAIN OUTCOME MEASURE(S): Correlation of OHSS symptoms with IAP; effects of paracentesis on IAP in patients with OHSS. SETTING: Academic Research Institution. INTERVENTION(S): None. RESULT(S): OHSS involves a rapid accumulation of volume (from 1.5-17 liters) in the peritoneal cavity that can lead to organ dysfunction, including respiratory impairment and oliguria. In published reports of 20 moderate-to-severe OHSS patients in whom IAP was measured, IAP was found to be elevated to a pathologic range. The increased IAP indicates that OHSS may be considered a compartment syndrome and meets criteria for abdominal compartment syndrome in advanced cases. For this reason, management of OHSS should include reduction of pressure by paracentesis to avoid morbidity and syndrome progression. In addition, measurement of IAP may help to classify the stage of OHSS. CONCLUSION(S): IAP was found to be elevated in the few cases of OHSS in which it was measured, substantiating the conclusion that OHSS may be considered a compartment syndrome. An understanding of the pathophysiology of increased intrabdominal pressure is useful in the management of OHSS. |
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Authors:
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Lisa C Grossman; Konstantinos G Michalakis; Hyacinth Browne; Mark D Payson; James H Segars |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Intramural; Review |
Journal Detail:
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Title: Fertility and sterility Volume: 94 ISSN: 1556-5653 ISO Abbreviation: Fertil. Steril. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-27 Completed Date: 2010-09-20 Revised Date: 2011-08-01 |
Medline Journal Info:
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Nlm Unique ID: 0372772 Medline TA: Fertil Steril Country: United States |
Other Details:
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Languages: eng Pagination: 1392-8 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010. Published by Elsevier Inc. |
Affiliation:
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Georgetown University School of Medicine, Washington, DC, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen
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blood supply,
physiopathology Algorithms Compartment Syndromes / classification, diagnosis*, etiology, physiopathology Diagnosis, Differential Female Hemodynamics / physiology Humans Hypertension / complications Ovarian Hyperstimulation Syndrome / diagnosis*, etiology*, physiopathology, therapy Paracentesis / methods |
| Grant Support | |
ID/Acronym/Agency:
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ZIA HD008737-09/HD/NICHD NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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