Lesson 6 (Part 4) Flashcards
What do hyperstimulated ovaries respond to?
Increased levels of hCG
What is hyperstimulated ovaries associated with?
Ovulation induction
What do ovarian blood vessels react abnormally to? (2)
- hCG
2. Leak fluid
What does hCG and leak fluid cause?
Ovaries to enlarged due to swelling from fluid
- if worsens fluid moves into abdomen
What is the sonographic appearance of hyperstimulated ovaries? (3)
- Bilaterally
- Enlarged ovaries
- Multiple cysts
When do hyperstimulated ovaries usually resolve?
During pregnancy
What risk is there with hyperstimulated ovaries?
Torsion
Why is there a high risk of torsion with hyperstimulated ovaries?
Because they have cysts on them
OHSS
Ovarian Hyperstimulation Syndrome
What does ovarian hyperstimulation syndrome result from?
Fertility drugs
What are 3 degrees syndrome meaning more than one symptom?
- Mild
- Moderate
- Severe
What happens in mild OHSS? (2)
- Ovaries enlarged but <5cm
2. Lower abdominal discomfort
What happens in moderate OHSS? (2)
- Weight gain 5 to 10 lbs
2. Ovaries measure between 5 and 12 cm
What can moderate OHSS cause? (2)
- Nausea
2. Vomiting
What happens in severe OHSS? (2)
- > 10 lb weight gain
2. Ovaries > 12cm in diameter, multiple large, thin walled cysts
What can severe OHSS cause? (2)
- Severe abdominal pain
2. Distension
What is severe OHSS associated with? (2)
- Ascites
2. Pleural effusions
Where should you look when you are dealing with severe OHSS?
In Morrisons pouch
What is the treatment for severe OHSS? (2)
- Conservative
- replace fluids and electrolytes - Resolves 2 to 3 weeks
What is theca luteal cysts associated with?
OHS
HL
Hyperractio Luteinalis
Hyperractio Luteinalis (2)
- Abnormal response to circulating hCG
2. Patient had no ovulation induction therapy
What are hyperractio luteinalis also known as?
Theca luteal in later pregnancy
When does HL mostly occur?
In the 3rd trimester
Who is HL most likely going to occur in?
A patient who has polycystic ovarian disease
What is rare with HL?
Body fluid shifts
Body fluid shifts
Ascites/pleura
What is the sonographic appearance of HL? (3)
- Bilateral
- Enlarged ovaries
- Multiple cysts
What are the differences between HL and OHS? (3)
- Occurs in 3rd trimester
- Ovaries are not as large
- Resolves spontaneously
What are some characteristics of luteoma? (4)
- Rare
- Solid
- Benign
- Most asymptomatic
What do luteinize stromal cells produce?
Androgens
Who is more at risk for luteoma? (2)
- Female fetus 50% risk virilization
2. Male fetus not affected
What does luteoma look like on US? (3)
- Heterogeneous
- Mostly hypoechoic mass
- Can be Highly vascular
What is the most common cause of luteoma?
Maternal virilization
