Ovarian Hyperstimulation Syndrome Flashcards
What is Ovarian hyper stimulation syndrome?
OHSS is a complication of fertility ttt (which uses pharmacological ovarian stimulation to inc. no. of oocyte, therefore embryos available during ART.
Underlying cause of OHSS
Exposure of ovaries to hCG or LH after controlled ovarian stimulation by FSH underlies most cases of OHSS
Cause of hypovolemia in OHSS patients
inc. vascular permeability leads to loss of fluid into the third space, manifesting as ascites or less commonly pleural or pericardial effusion.
women w/ severe OHSS have hypovolemia, with typical loss of 20% of their blood vol. in acute phase of OHSS
Percentage of mild OHSS
1/3 of all cases of IVF
Percentage of moderate to severe cases of OHSS
3-8%
Difference between early and late OHSS
Early: within 7 days of hcg inj
Late: after 10 days
For how long progesterone support be given
8 weeks of gestation
Risk of thrombosis in OHSS & what type of thrombosis occurs?
Upper body arterial
0.7–10%
When & where do we report OHSS?
Verbal in 12 hours
written in 24 hours
Severe & critical to HEFAE
How long do u give VTE prophylaxis in OHSS?
if pt is not pregnant and only has severe ohss and admitted we will give vte prophylaxis during hospital stay
And If she gets pregnant then till end of 1st trimester
Which site of the uterus is more prone for Perforation?
Anterior wall 40%
Cervical canal 36%
Rt lateral wall 21%
Lt lateral wall 17%
Posterior wall 13%
Fundus 13%
which instrument is more prone for uterine Perforation?
Suction cannula 51%
Hagar dilator 24%
Curette 16%
What’s the risk of perforation with ERPOC in PPH?
5% & more with nulliparous
What’s the BMI which needs to be reduced in DM pre conception?
> 27 kg/m2
In case of OHSS why do we avoid NSAIDs
They may compromise renal function
