Clinical Analyses For 73 Patients Of Moderate And Severe Ovarian Hyperstimulation Syndrome

Objective:To review and to summarize clinical character of Ovarian Hyperstimulation Syndrome, providing evidences on its clinical observation, therapy and monitoring.Methods:Choosing 73 patients of ovarian hyperstimulation syndrome hospitalized in the second hospital, hebei medical university between January 2008 and December 2014, They were devided into moderate OHSS and severe OHSS, according to Golan standard. Increasing on permeability of Capillary vessel and fluid extravasation led to hemoconcentration as well as decreasing on blood volume, and We could have a knowledge of degree of hemoconcentration through hematocrit.We tried to explore the relation between blood hematocrit and the degree of OHSS. Now pathogenesis of OHSS wasn’t clear.A large number of scientific evidences showed that polycystic ovarian syndrome(PCOS) was high risk factor of OHSS. Based on these evidences,let’s analyse whether PCOS influenced severe degree of OHSS. 73 patients were devided into pregnant team and not pregnant team,and compared degree of OHSS, hospitalization days and albumin consumption. drainage of ascites was common used for OHSS,and whether it could shorten course of disease were our main research content. Aslo we explored clinical character of OHSS through age, symptoms, sign, assisted examination and therapy. SPSS 13.0 statistical software is applied for analysis and the measurement data is described in x±s. The comparison between the two groups adopt t-test; Count data expressed as a percentage(%); Classfication of variables in the two groups by X2 test and Fisher’s exact probability method. P<0.05 was statistically significant.Results:1 Age we devided age into four groups,and that was 20-25, 26-30, 31-35, equal or larger 35 years old. 46 cases mainly distributed in 26-30 years old, about 63% of the total.2 The relation between PCOS and degree of OHSS:73 OHSS patients contains 22 cases with PCOS, 6 cases in moderate OHSS and 16 cases in severe OHSS. Without PCOS cases had a large portion in 73 OHSS patients, 28 cases in moderate OHSS and 23 cases in severe OHSS. After comparison between two teams, P = 0.027(P < 0.05), the difference was statistically significant.3 The relationship between pregnancy and OHSS severity:in this research, in the 14 cases with pregnancies, 3 cases(21.43%) is moderate OHSS, 11 cases(78.57%) is severe OHSS; and in 59 patients without pregnancy, 31 cases(52.54%)is mild OHSS, 28 cases(47.46%) is severe OHSS; both comparison, P = 0.034(P < 0.05), the difference was statistically significant.4 Symptoms 17 cases of abdominal distension appeared in moderate OHSS and 28 cases in severe OHSS. About abdominal pain,there were 9 cases in moderate OHSS and 9 cases in severe OHSS. People could’t lin on the back with dyspnea had 2 cases in moderate and 11 cases in severe OHSS. At the same time, 5 cases had a syptom of chest distress in moderate and 11 cases in severe OHSS. Nausea and vomiting made patients fell bad, including 11 cases moderate and 13 cases severe. There were 1 cases in moderate and 2 cases in severe OHSS about oliguria. 2 cases anasarca patients were included in severe OHSS.1 cases hydropericardium appeared in severe OHSS, and there was no case in moderate OHSS. Meanwhile, sinus thrombosis was found in severe OHSS.5 Hematocrit and OHSS Hct value in 34 patients with moderate OHSS is(38.94 ± 4.34) %, and in 39 patients with severe OHSS is(42.06 ±6.80) %, both comparison, P = 0.067(P > 0.05), have no statistical difference, and suggests that severe OHSS group blood concentration degree is not higher than moderate OHSS.6 drainage of ascites 10 cases of 34 cases moderate OHSS made large volum paracentesis, and average putting ascites was 1.7 times per person as well as average volume of ascites was 4355 ml per person. 39 cases severe OHSS had a portion of 22 cases putting ascites, and 2.1 times per person as well 5226 ml per person. 3 cases also complished ovarian cyst puncture while abdominocentesis.7 Pregnancy and the length of course in patients with OHSS :13 cases OHSS patients with pregnancy average hospitalization days was 15.38±8.25 days, while 59 cases OHSS patients without pregnancy was 6.84± 2.73 days, both comparison, P = 0.013(P < 0.01), statistically significant.8 Pregnancy and dosage of albumin in the OHSS patients:Dosage of albumin in the OHSS patients with pregnancy was 195.94 ±160.99 g, and patients without pregnancy was 65.63±42.42 g, both compariso-n, P = 0.001(P < 0.01), there was statistically significant.Conclusion:1 There was no significant difference in Hct between patients with severe OHSS and moderate OHSS. Namely, the Hct cannot reflect the OHSS patients, condition and blood concentration degree is not related with clinical severity. But estradiol levels in moderate OHSS and severe OHSS have significant difference, the higher estradiol levels, themore obvious clinical symptoms.2 Compared with OHSS patients without pregnancy, the patients with pregnancy had more severe clinical symptoms, longer duration, more dosage of albumin. Pregnancy may aggravate OHSS condition and delay the course of disease. It is necessary to increase the dosage of albumin in the process of treatment.3 OHSS patients with drainage of ascites and without drainage of ascites had no statistical significance in hospitalization days, drainage of ascites treatment cannot shorten the course of disease evidently.