Treatment of severe ovarian hyperstimulation syndrome by a conservative medical approach.
OBJECTIVE
To assess the value of a conservative medical therapeutic approach in the management of severe ovarian hyperstimulation syndrome (OHSS).


METHODS
Prospective longitudinal study.


METHODS
Assisted Reproduction Unit of the Hospital Clínic i Provincial de Barcelona, a tertiary care setting.


METHODS
Twenty-five women with ascites because of OHSS.


METHODS
Patients were treated by strict bed rest, low-sodium diet (60 mEq/day), plasma volume expansion with albumin (50 g/day of salt-poor albumin) and diuretics (20 mg of furosemide given intravenously every 8-12 hours).


METHODS
Measurement at admission and 48 hours after commencement of treatment of the following: body weight, mean arterial pressure, heart rate, hematocrit, hemoglobin concentration, leukocyte and platelet counts, urine volume, sodium excretion, serum sodium, serum creatinine, plasma renin activity, and plasma aldosterone, norepinephrine, antidiuretic hormone, and atrial natriuretic peptide concentrations.


RESULTS
After 2 days of therapy there was marked improvement in clinical symptoms, standard laboratory parameters, diuresis and urinary sodium excretion in all patients. There was also a significant decrease in the plasma levels of volume-dependent endogenous vasoactive substances in the five patients in whom these measurements were repeated during treatment. The length of treatment with albumin plus furosemide ranged between 2 and 6 days with an average of 3.3 and it correlated directly with the severity of the syndrome. The hospital stay ranged from 4 to 10 days (mean 6.5 days). All patients recovered without any complication.


CONCLUSIONS
Severe ovarian hyperstimulation syndrome can be managed using the proposed conservative medical approach.
Balasch
J
J
Department of Obstetrics and Gynecology, Hospital Clinic i Provincial, University of Barcelona, Spain.
Fábregues
F
F
Arroyo
V
V
Jiménez
W
W
Creus
M
M
Vanrell
J A
JA
D000328:Adult; D001510:Bed Rest; D004039:Diet, Sodium-Restricted; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009318:Natriuresis; D016471:Ovarian Hyperstimulation Syndrome / Q000473:pathology / Q000628:therapy*; D011446:Prospective Studies
D004232:Diuretics