Ovarian hyperstimulation syndrome - Revision history

Rossdonaldson1: /* Evaluation */

2024-12-11T20:56:44Z

Evaluation

← Older revision		Revision as of 20:56, 11 December 2024
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	==Evaluation==		==Evaluation==
			[[File:Vaginal ultrasonography in mild ovarian hyperstimulation syndrome - coronal.jpg\|thumb\|Vaginal ultrasonography in mild ovarian hyperstimulation syndrome (coronal).]]
	[[File:Vaginal ultrasonography in mild ovarian hyperstimulation syndrome - sagittal.jpg\|thumb\|Pelvic ultrasound (sagittal) in woman with OHSS showing ascites and enlarged ovary (diameter = 6.5mm)]]		[[File:Vaginal ultrasonography in mild ovarian hyperstimulation syndrome - sagittal.jpg\|thumb\|Pelvic ultrasound (sagittal) in woman with OHSS showing ascites and enlarged ovary (diameter = 6.5mm)]]
	===Workup===		===Workup===

2024-12-11T20:51:24Z

Background

← Older revision		Revision as of 20:51, 11 December 2024
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	==Background==		==Background==
			[[File:Blausen 0732 PID-Sites.png\|thumb\|Female pelvic anatomy.]]
	*Fertility treatments causing development of multiple follicles at once		*Fertility treatments causing development of multiple follicles at once
	**Exaggerated ovarian response to ovulation induction (esp in IVF when HCG is used to stimulate)		**Exaggerated ovarian response to ovulation induction (esp in IVF when HCG is used to stimulate)

2020-04-15T19:06:20Z

Workup

← Older revision		Revision as of 19:06, 15 April 2020
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	[[File:Vaginal ultrasonography in mild ovarian hyperstimulation syndrome - sagittal.jpg\|thumb\|Pelvic ultrasound (sagittal) in woman with OHSS showing ascites and enlarged ovary (diameter = 6.5mm)]]		[[File:Vaginal ultrasonography in mild ovarian hyperstimulation syndrome - sagittal.jpg\|thumb\|Pelvic ultrasound (sagittal) in woman with OHSS showing ascites and enlarged ovary (diameter = 6.5mm)]]
	===Workup===		===Workup===
	*Urine pregnancy		*Urine or serum pregnancy
	**'''[[Beta-HCG]] may be positive if [[beta-HCG]] injection given as part of fertility treatment'''		**'''[[Beta-HCG]] may be positive if [[beta-HCG]] injection given as part of fertility treatment, consider obtaining beta quantitative instead of qualitative'''
	*CBC		*CBC
	*Chem 10		*Chem 10

2019-11-28T19:10:53Z

Differential Diagnosis

← Older revision		Revision as of 19:10, 28 November 2019
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Ectopic ~~Pregnancy~~]]		*[[Ectopic pregnancy]]
	*[[Molar ~~Pregnancy~~]]		*[[Molar pregnancy]]
	*[[Sepsis]]		*[[Sepsis]]
	*[[PE]]		*[[Pulmonary embolism in pregnancy]]

	{{Pelvic pain DDX}}		{{Pelvic pain DDX}}

2019-11-28T19:07:56Z

Evaluation

← Older revision		Revision as of 19:07, 28 November 2019
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	==Evaluation==		==Evaluation==
	[[File:Vaginal ultrasonography in mild ovarian hyperstimulation syndrome - sagittal.jpg\|thumb\|Pelvic ultrasound (sagittal ~~plane~~) in woman with OHSS showing ascites and enlarged ovary (diameter = 6.5mm)]]		[[File:Vaginal ultrasonography in mild ovarian hyperstimulation syndrome - sagittal.jpg\|thumb\|Pelvic ultrasound (sagittal) in woman with OHSS showing ascites and enlarged ovary (diameter = 6.5mm)]]
	===Workup===		===Workup===
	*Urine pregnancy		*Urine pregnancy

2019-11-28T19:07:17Z

Evaluation

← Older revision		Revision as of 19:07, 28 November 2019
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	==Evaluation==		==Evaluation==
	[[File:Vaginal ultrasonography in mild ovarian hyperstimulation syndrome - sagittal.jpg\|thumb\|Pelvic ultrasound (sagittal plane) in woman with ~~mild~~ OHSS~~: 33 mm wide anechogenic area in the recto-uterine pouch of free fluid. Ovary measured~~ 6.~~5 cm in diameter.~~]]		[[File:Vaginal ultrasonography in mild ovarian hyperstimulation syndrome - sagittal.jpg\|thumb\|Pelvic ultrasound (sagittal plane) in woman with OHSS showing ascites and enlarged ovary (diameter = 6.5mm)]]
	===Workup===		===Workup===
	*Urine pregnancy		*Urine pregnancy

2019-11-28T19:04:45Z

Evaluation

← Older revision		Revision as of 19:04, 28 November 2019
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	==Evaluation==		==Evaluation==
			[[File:Vaginal ultrasonography in mild ovarian hyperstimulation syndrome - sagittal.jpg\|thumb\|Pelvic ultrasound (sagittal plane) in woman with mild OHSS: 33 mm wide anechogenic area in the recto-uterine pouch of free fluid. Ovary measured 6.5 cm in diameter.]]
	===Workup===		===Workup===
	*Urine pregnancy		*Urine pregnancy
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	\|\|Worsening findings		\|\|Worsening findings
	\|}		\|}



	==Management==		==Management==

2019-11-05T17:11:55Z

Background

← Older revision		Revision as of 17:11, 5 November 2019
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	==Background==		==Background==
	*Fertility treatments causing development of multiple follicles at once		*Fertility treatments causing development of multiple follicles at once
	*Fluid shifts out of vasculature		**Exaggerated ovarian response to ovulation induction (esp in IVF when HCG is used to stimulate)
			*Fluid shifts out of vasculature (third spacing)
			*Typically 5-10d after 1st dose
			*Ranges in severity from mild to severe multiorgan dysfunction, relating in part to massive intravascular fluid shifts

	==Clinical Features==		==Clinical Features==

2019-09-14T14:27:27Z

← Older revision		Revision as of 14:27, 14 September 2019
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	*Movement of fluid out of vasculature		*Movement of fluid out of vasculature
	**[[Ascites]]		**[[Ascites]]
	**Pleural effusions		**[[Pleural effusions]]
	**Pericardial effusion		**[[Pericardial effusion]]
	**[[Hypotension]]		**[[Hypotension]]
	*[[Electrolyte ~~Imbalances~~]]		*[[Electrolyte imbalances]]
	*[[DIC]]		*[[DIC]]
	*[[Thromboembolism]]		*[[Thromboembolism]]
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	==Differential Diagnosis==		==Differential Diagnosis==
	*[[Ectopic Pregnancy]]		*[[Ectopic Pregnancy]]
	*Molar Pregnancy		*[[Molar Pregnancy]]
	*[[Sepsis]]		*[[Sepsis]]
	*[[PE]]		*[[PE]]
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	*Chem 10		*Chem 10
	*PT/PTT		*PT/PTT
	*Pelvic ultrasound		*[[Pelvic ultrasound]]
	*Consider:		*Consider:
	**[[CXR]] (rule out [[pleural effusion]])		**[[CXR]] (rule out [[pleural effusion]])
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	===Moderate===		===Moderate===
	*[[IV fluids]] (e.g normal saline)		*[[IV fluids]] (e.g normal saline)
	*~~Threaputic~~ [[paracentesis]] if ascites (aspirate 0.5-4 L)		*Therapeutic [[paracentesis]] if [[ascites]] (aspirate 0.5-4 L)
	*Thromboembolic prophylaxis (e.g. [[LMWH]])		*Thromboembolic prophylaxis (e.g. [[LMWH]])
	**All hospitalized patients		**All hospitalized patients

2016-11-13T21:45:31Z

Text replacement - " US " to " ultrasound "

← Older revision		Revision as of 21:45, 13 November 2016
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	*Consider:		*Consider:
	**[[CXR]] (rule out [[pleural effusion]])		**[[CXR]] (rule out [[pleural effusion]])
	**Cardiac US (rule out [[pericardial effusion]])		**Cardiac [[ultrasound]] (rule out [[pericardial effusion]])
	**Progesterone level		**Progesterone level
	**Estradiol level		**Estradiol level