Abstract

SAAVEDRA SAAVEDRA, Jaime. Ovarian hyperstimulation syndrome: classification, physiopathology and management. Rev Colomb Obstet Ginecol [online]. 2002, vol.53, n.3, pp.263-278. ISSN 0034-7434.

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of ovulation induction by gonadotropins. The syndrome can result in serious life threatening complications, which include cerebrovascular accidents due to venous thrombosis, liver dysfunction, acute renal failure, respiratory complications and adnexal torsion. It is known that the most important predisposing factor for the development of severe forms of OHSS is polycystic ovarian disease. The syndrome is characterized by leakage of fluid from the intravascular compartment, with accumulation of fluid in the peritoneal and pleural cavities, resulting in hypotension and a decrease in renal blood flow and volume of urine. Increase capillary permeability is the most accepted hypothesis for the initial pathophysiological event. Vascular endothelial growth factor and other cytokines are pivotal in the pathogenesis of OHSS. The classification of the syndrome, let us make logic treatment schemes, therefore, the mild OHSS requires only rest and oral hydration. The moderate OHSS is treated with ambulatory observation, bed rest, analgesics, sonographic surveillance, evaluation of the renal and hepatic function, and vigilance of the hematocrit and coagulation factors. Severe OHSS, without an abnormal biochemical profile, is treated by ascitic fluid aspiration and intravenous fluid therapy on the basis of day care treatment. Cases of severe OHSS with electrolyte imbalance or other complications must be admitted to the hospital for appropriate treatment. Surgical treatment is reserved for torsion or rupture of adnexal cystic or treatment of ectopic pregnancy.

Keywords : Gonadotropins; ovarian hyperstimulation; classification; treatment.

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