Ovarian Hyperstimulation Syndrome (OHSS): A Narrative Review and Legal Implications
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
4.1. Weighing All Risk Factors
4.2. Ovarian Reserve and OHSS Pathophysiology
4.3. Evidence-Based Therapeutic Options
4.4. Guidelines Delineate Therapeutic Pathways for Medicolegal Soundness
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Symptoms Frequency | Always | Usually | Often | Rarely |
---|---|---|---|---|
Mild OHSS | Enlargement of bilateral ovaries with multiple follicular. | Corpus luteal cysts, measuring up to 8 cm. | Abdominal bloating and mild abdominal pain. | |
Moderate OHSS | Ovaries up to 12 cm. | Abdominal bloating due to an increase in ovarian size. | Gastrointestinal symptoms (nausea, vomiting and diarrhea). | Ultrasound evidence of ascites and rapid weight gain of over 2.5–3 kg. |
Severe OHSS | Large ovarian cysts (>12 × 12 cm), clinical ascites with or without hydrothorax. | Hyperkalemia (potassium > 5 mmol/L), hyponatremia (sodium < 135 mmol/L). | Oliguria (<300 mL/d or <30 mL/h), creatinine 1.1–1.5 mg/dL, and hypovolemic shock. Hemoconcentration with hematocrit > 45%, white cell count > 15,000. | Liver dysfunction, increased blood viscosity, and thromboembolic. |
Critical OHSS | Severe ascites or hydrothorax, hematocrit > 55%, white cell count > 25,000/mL. | Oliguria or anuria, creatinine ≥ 1.6 mg/dL, creatinine clearance < 50 mL/min. | Thromboembolism, or acute respiratory distress syndrome. |
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Gullo, G.; Cucinella, G.; Stojanovic, V.; Stojkovic, M.; Bruno, C.; Streva, A.V.; Lopez, A.; Perino, A.; Marinelli, S. Ovarian Hyperstimulation Syndrome (OHSS): A Narrative Review and Legal Implications. J. Pers. Med. 2024, 14, 915. https://doi.org/10.3390/jpm14090915
Gullo G, Cucinella G, Stojanovic V, Stojkovic M, Bruno C, Streva AV, Lopez A, Perino A, Marinelli S. Ovarian Hyperstimulation Syndrome (OHSS): A Narrative Review and Legal Implications. Journal of Personalized Medicine. 2024; 14(9):915. https://doi.org/10.3390/jpm14090915
Chicago/Turabian StyleGullo, Giuseppe, Gaspare Cucinella, Vukasin Stojanovic, Mirjana Stojkovic, Carmine Bruno, Adriana Vita Streva, Alessandra Lopez, Antonio Perino, and Susanna Marinelli. 2024. "Ovarian Hyperstimulation Syndrome (OHSS): A Narrative Review and Legal Implications" Journal of Personalized Medicine 14, no. 9: 915. https://doi.org/10.3390/jpm14090915