Ovarian Hyperstimulation Syndrome as an Etiology of Obstructive Uropathy
Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of controlled ovarian hyperstimulation (COH) protocols performed in women undergoing assisted reproductive technologies. Overstimulation of the ovaries results in the overproduction of vasoactive cytokines and mediators by the ov...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Obstetrics and Gynecology |
| Online Access: | http://dx.doi.org/10.1155/2013/653704 |
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| author | Creticus P. Marak Amit Chopra Narendrakumar Alappan Ana M. Ponea Achuta K. Guddati |
| author_facet | Creticus P. Marak Amit Chopra Narendrakumar Alappan Ana M. Ponea Achuta K. Guddati |
| author_sort | Creticus P. Marak |
| collection | DOAJ |
| description | Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of controlled ovarian hyperstimulation (COH) protocols performed in women undergoing assisted reproductive technologies. Overstimulation of the ovaries results in the overproduction of vasoactive cytokines and mediators by the ovaries, thereby causing a generalized capillary leak and acute shift of protein-rich fluid from the intravascular compartment into the third space. This may lead to the development of ascites, pleural effusions, pericardial effusion, anasarca, intravascular volume depletion, hemoconcentration, oliguria, hypoalbuminemia and hypoproteinemia, electrolyte imbalances, acute renal failure, abdominal compartment syndrome, thromboembolic events, and adult respiratory distress syndrome. The only effective treatment available is prevention of the syndrome from developing by individualizing the stimulation protocol, especially in high-risk patients. Once the syndrome develops, the management is mainly supportive. Oliguria and some degree of acute renal failure commonly develop in patients with moderate to severe OHSS and are usually due to prerenal causes. Acute renal failure (ARF) secondary to obstructive uropathy is rare. Here we report a case of severe, life-threatening OHSS resulting in ARF secondary to obstructive uropathy. |
| format | Article |
| id | doaj-art-a487f4888dff422db6ac8f4ae5e35109 |
| institution | Kabale University |
| issn | 2090-6684 2090-6692 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Obstetrics and Gynecology |
| spelling | doaj-art-a487f4888dff422db6ac8f4ae5e351092025-02-03T06:04:57ZengWileyCase Reports in Obstetrics and Gynecology2090-66842090-66922013-01-01201310.1155/2013/653704653704Ovarian Hyperstimulation Syndrome as an Etiology of Obstructive UropathyCreticus P. Marak0Amit Chopra1Narendrakumar Alappan2Ana M. Ponea3Achuta K. Guddati4Division of Pulmonary and Critical Care Medicine, Montefiore Hospital, Albert Einstein College of Medicine, Yeshiva University, New York, NY 10467, USADivision of Pulmonary and Critical Care Medicine, Montefiore Hospital, Albert Einstein College of Medicine, Yeshiva University, New York, NY 10467, USADivision of Pulmonary and Critical Care Medicine, Montefiore Hospital, Albert Einstein College of Medicine, Yeshiva University, New York, NY 10467, USADivision of Pulmonary and Critical Care Medicine, Montefiore Hospital, Albert Einstein College of Medicine, Yeshiva University, New York, NY 10467, USADepartment of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Harvard University, Boston, MA 02114, USAOvarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of controlled ovarian hyperstimulation (COH) protocols performed in women undergoing assisted reproductive technologies. Overstimulation of the ovaries results in the overproduction of vasoactive cytokines and mediators by the ovaries, thereby causing a generalized capillary leak and acute shift of protein-rich fluid from the intravascular compartment into the third space. This may lead to the development of ascites, pleural effusions, pericardial effusion, anasarca, intravascular volume depletion, hemoconcentration, oliguria, hypoalbuminemia and hypoproteinemia, electrolyte imbalances, acute renal failure, abdominal compartment syndrome, thromboembolic events, and adult respiratory distress syndrome. The only effective treatment available is prevention of the syndrome from developing by individualizing the stimulation protocol, especially in high-risk patients. Once the syndrome develops, the management is mainly supportive. Oliguria and some degree of acute renal failure commonly develop in patients with moderate to severe OHSS and are usually due to prerenal causes. Acute renal failure (ARF) secondary to obstructive uropathy is rare. Here we report a case of severe, life-threatening OHSS resulting in ARF secondary to obstructive uropathy.http://dx.doi.org/10.1155/2013/653704 |
| spellingShingle | Creticus P. Marak Amit Chopra Narendrakumar Alappan Ana M. Ponea Achuta K. Guddati Ovarian Hyperstimulation Syndrome as an Etiology of Obstructive Uropathy Case Reports in Obstetrics and Gynecology |
| title | Ovarian Hyperstimulation Syndrome as an Etiology of Obstructive Uropathy |
| title_full | Ovarian Hyperstimulation Syndrome as an Etiology of Obstructive Uropathy |
| title_fullStr | Ovarian Hyperstimulation Syndrome as an Etiology of Obstructive Uropathy |
| title_full_unstemmed | Ovarian Hyperstimulation Syndrome as an Etiology of Obstructive Uropathy |
| title_short | Ovarian Hyperstimulation Syndrome as an Etiology of Obstructive Uropathy |
| title_sort | ovarian hyperstimulation syndrome as an etiology of obstructive uropathy |
| url | http://dx.doi.org/10.1155/2013/653704 |
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