Skip to main content
Top
Published in: Journal of Ovarian Research 1/2014

Open Access 01-12-2014 | Brief communication

Pregnancy outcome in severe OHSS patients following ascitic/plerural fluid drainage

Authors: Jigal Haas, Yoav Yinon, Katya Meridor, Raoul Orvieto

Published in: Journal of Ovarian Research | Issue 1/2014

Login to get access

Abstract

Background

Various inflammatory cytokines have been implicated in the pathophysiology of severe ovarian hyperstimulation syndrome, as well as, various pregnancy complications, including preterm labor, pregnancy induced hypertension/preeclampsia and intra-uterine growth restriction. We aim to determine whether severe OHSS, complicated by third space fluid accumulation necessitating drainage, is associated with increased risk of late obstetrics complications.

Methods

We assessed the obstetrics and neonatal outcome measures of 16 patients admitted to our gynecology ward during a 6-year period, with severe OHSS complicated by third space fluid accumulation necessitating drainage.

Results

Patients delivered at 37.3 ± 5.9weeks, with a mean birth weight of 3062 ± 757 gr. There was no single case of gestational diabetes, hypertensive diseases of pregnancy, nor placental abruption. Two (12.5%) patients had preterm delivery: one at 23 weeks’ gestation and one at 28 weeks’ gestation following preterm premature rupture of membrane. Another patient experienced an unexplained antepartum fetal death at 27 weeks’ gestation.

Conclusions

Severe OHSS, complicated by third space fluid sequestration necessitating drainage, is not associated with adverse late pregnancy outcome, except probably for preterm labor. Following resolution of the OHSS, pregnancies should be regarded as any pregnancy resulting from IVF treatment, with special attention to prevent preterm labor.
Literature
1.
go back to reference Navot D, Bergh PA, Laufer N: Ovarian hyperstimulation syndrome in novel reproductive technologies: prevention and treatment. Fertil Steril 1992, 58: 249–261.PubMed Navot D, Bergh PA, Laufer N: Ovarian hyperstimulation syndrome in novel reproductive technologies: prevention and treatment. Fertil Steril 1992, 58: 249–261.PubMed
2.
go back to reference Delvigne A, Rozenberg S: Review of clinical course and treatment of ovarian hyperstimulation syndrome (OHSS). Hum Reprod Update 2003, 9: 77–96. 10.1093/humupd/dmg005CrossRefPubMed Delvigne A, Rozenberg S: Review of clinical course and treatment of ovarian hyperstimulation syndrome (OHSS). Hum Reprod Update 2003, 9: 77–96. 10.1093/humupd/dmg005CrossRefPubMed
3.
go back to reference Orvieto R, Ben-Rafael Z: Ovarian hyperstimulation syndrome: a new insight into an old enigma. J Soc Gynecol Investiq 1998, 5: 110–113. 10.1016/S1071-5576(97)00113-5CrossRef Orvieto R, Ben-Rafael Z: Ovarian hyperstimulation syndrome: a new insight into an old enigma. J Soc Gynecol Investiq 1998, 5: 110–113. 10.1016/S1071-5576(97)00113-5CrossRef
4.
go back to reference Mashiach S, Bider D, Moran O, Goldenberg M, Ben-Rafael Z: Adnexal torsion of hyperstimulated ovaries in pregnancies after gonadotropin therapy. Fertil Steril 1990, 53: 76–80.PubMed Mashiach S, Bider D, Moran O, Goldenberg M, Ben-Rafael Z: Adnexal torsion of hyperstimulated ovaries in pregnancies after gonadotropin therapy. Fertil Steril 1990, 53: 76–80.PubMed
5.
go back to reference Orvieto R, Schwartz A, Bar Hava I, Abir R, Ashkenazi J, La-Marca A: Controlled ovarian hyperstimulation- a state of endothelial activation. Am J Reprod Immunol 2000, 44: 257–60. 10.1111/j.8755-8920.2000.440501.xCrossRefPubMed Orvieto R, Schwartz A, Bar Hava I, Abir R, Ashkenazi J, La-Marca A: Controlled ovarian hyperstimulation- a state of endothelial activation. Am J Reprod Immunol 2000, 44: 257–60. 10.1111/j.8755-8920.2000.440501.xCrossRefPubMed
6.
go back to reference Orvieto R: Controlled ovarian hyperstimulation- an inflammatory state. J Soc Gynecol Investiq 2004, 11: 424–426. 10.1016/j.jsgi.2004.05.001CrossRef Orvieto R: Controlled ovarian hyperstimulation- an inflammatory state. J Soc Gynecol Investiq 2004, 11: 424–426. 10.1016/j.jsgi.2004.05.001CrossRef
7.
go back to reference Gomez R, Soares SR, Busso C, Garcia-Velasco JA, Simon C, Pellicer A: Physiology and pathology of ovarian hyperstimulation syndrome. Semin Reprod Med 2010, 28: 448–457. 10.1055/s-0030-1265670CrossRefPubMed Gomez R, Soares SR, Busso C, Garcia-Velasco JA, Simon C, Pellicer A: Physiology and pathology of ovarian hyperstimulation syndrome. Semin Reprod Med 2010, 28: 448–457. 10.1055/s-0030-1265670CrossRefPubMed
8.
go back to reference Friedlander MA, Loret de Mola JR, Goldfarb JM: Elevated levels of interleukin-6 in ascites and serum from women with ovarian hyperstimulation syndrome. Fertil Steril 1993, 60: 826–833.PubMed Friedlander MA, Loret de Mola JR, Goldfarb JM: Elevated levels of interleukin-6 in ascites and serum from women with ovarian hyperstimulation syndrome. Fertil Steril 1993, 60: 826–833.PubMed
9.
go back to reference Chen CD, Wu MY, Chen HF, Chen SU, Ho HN, Yang YS: Prognostic importance of serial cytokine changes in ascites and pleural effusion in women with severe ovarian hyperstimulation syndrome. Fertil Steril 1999, 72: 286–292. 10.1016/S0015-0282(99)00206-XCrossRefPubMed Chen CD, Wu MY, Chen HF, Chen SU, Ho HN, Yang YS: Prognostic importance of serial cytokine changes in ascites and pleural effusion in women with severe ovarian hyperstimulation syndrome. Fertil Steril 1999, 72: 286–292. 10.1016/S0015-0282(99)00206-XCrossRefPubMed
10.
go back to reference Garcia-Velasco JA, Pellicer A: New concepts in the understanding of the ovarian hyperstimulation syndrome. Curr Opin Obstet Gynecol 2003, 15: 251–256. 10.1097/00001703-200306000-00007CrossRefPubMed Garcia-Velasco JA, Pellicer A: New concepts in the understanding of the ovarian hyperstimulation syndrome. Curr Opin Obstet Gynecol 2003, 15: 251–256. 10.1097/00001703-200306000-00007CrossRefPubMed
11.
go back to reference Gomez-Lopez N, Vega-Sanchez R, Castillo-Castrejon M, Romero R, Cubeiro-Arreola K, Vadillo-Ortega F: Evidence for a role for the adaptive immune response in human term parturition. Am J Reprod Immunol 2013, 69: 212–230. 10.1111/aji.12074PubMedCentralCrossRefPubMed Gomez-Lopez N, Vega-Sanchez R, Castillo-Castrejon M, Romero R, Cubeiro-Arreola K, Vadillo-Ortega F: Evidence for a role for the adaptive immune response in human term parturition. Am J Reprod Immunol 2013, 69: 212–230. 10.1111/aji.12074PubMedCentralCrossRefPubMed
12.
go back to reference Laresgoiti-Servitje E: A leading role for the immune system in the pathophysiology of preeclampsia. J Leukoc Biol 2013, 94: 247–257. 10.1189/jlb.1112603CrossRefPubMed Laresgoiti-Servitje E: A leading role for the immune system in the pathophysiology of preeclampsia. J Leukoc Biol 2013, 94: 247–257. 10.1189/jlb.1112603CrossRefPubMed
13.
go back to reference Chaiworapongsa T, Espinoza J, Gotsch F, Kim YM, Kim GJ, Goncalves LF, Edwin S, Kusanovic JP, Erez O, Than NG, Hassan SS, Romero R: The maternal plasma soluble vascular endothelial growth factor receptor-1 concentration is elevated in SGA and the magnitude of the increase relates to Doppler abnormalities in the maternal and fetal circulation. J Matern Fetal Neonatal Med 2008, 21: 25–40. 10.1080/14767050701832833CrossRefPubMed Chaiworapongsa T, Espinoza J, Gotsch F, Kim YM, Kim GJ, Goncalves LF, Edwin S, Kusanovic JP, Erez O, Than NG, Hassan SS, Romero R: The maternal plasma soluble vascular endothelial growth factor receptor-1 concentration is elevated in SGA and the magnitude of the increase relates to Doppler abnormalities in the maternal and fetal circulation. J Matern Fetal Neonatal Med 2008, 21: 25–40. 10.1080/14767050701832833CrossRefPubMed
14.
go back to reference Abramov Y, Elchalal U, Schenker JG: Obstetric outcome of in vitro fertilized pregnancies complicated by severe ovarian hyperstimulation syndrome: a multicenter study. Fertil Steril 1998, 70: 1070–1076. 10.1016/S0015-0282(98)00350-1CrossRefPubMed Abramov Y, Elchalal U, Schenker JG: Obstetric outcome of in vitro fertilized pregnancies complicated by severe ovarian hyperstimulation syndrome: a multicenter study. Fertil Steril 1998, 70: 1070–1076. 10.1016/S0015-0282(98)00350-1CrossRefPubMed
15.
go back to reference Wiser A, Levron J, Kreizer D, Achiron R, Shrim A, Schiff E, Dor J, Shulman A: Outcome of pregnancies complicated by severe ovarian hyperstimulation syndrome (OHSS): a follow-up beyond the second trimester. Hum Reprod 2005, 20: 910–914.CrossRefPubMed Wiser A, Levron J, Kreizer D, Achiron R, Shrim A, Schiff E, Dor J, Shulman A: Outcome of pregnancies complicated by severe ovarian hyperstimulation syndrome (OHSS): a follow-up beyond the second trimester. Hum Reprod 2005, 20: 910–914.CrossRefPubMed
16.
go back to reference Courbiere B, Oborski V, Braunstein D, Desparoir A, Noizet A, Gamerre M: Obstetric outcome of women with in vitro fertilization pregnancies hospitalized for ovarian hyperstimulation syndrome: a case–control study. Fertil Steril 2011, 95: 1629–332. 10.1016/j.fertnstert.2010.12.015CrossRefPubMed Courbiere B, Oborski V, Braunstein D, Desparoir A, Noizet A, Gamerre M: Obstetric outcome of women with in vitro fertilization pregnancies hospitalized for ovarian hyperstimulation syndrome: a case–control study. Fertil Steril 2011, 95: 1629–332. 10.1016/j.fertnstert.2010.12.015CrossRefPubMed
17.
go back to reference Haas J, Baum M, Meridor K, Hershko- Klement A, Elizur S, Hourvitz A, Orvieto R, Yinon Y: Is severe ovarian hyperstimulation syndrome associated with adverse pregnancy outcome? Evidence from a large case–control study. Reprod Biol (accepted for publication- 2014; in press) Haas J, Baum M, Meridor K, Hershko- Klement A, Elizur S, Hourvitz A, Orvieto R, Yinon Y: Is severe ovarian hyperstimulation syndrome associated with adverse pregnancy outcome? Evidence from a large case–control study. Reprod Biol (accepted for publication- 2014; in press)
18.
go back to reference Golan A, Ron-el R, Herman A, Soffer Y, Weinraub Z, Caspi E: Ovarian hyperstimulation syndrome: an update review. Obstet Gynecol Surv 1989, 44: 430–440. 10.1097/00006254-198906000-00004CrossRefPubMed Golan A, Ron-el R, Herman A, Soffer Y, Weinraub Z, Caspi E: Ovarian hyperstimulation syndrome: an update review. Obstet Gynecol Surv 1989, 44: 430–440. 10.1097/00006254-198906000-00004CrossRefPubMed
19.
go back to reference Lyons CA, Wheeler CA, Frishman GN, Hackett RJ, Seifer DB, Haning RV Jr: Early and late presentation of the ovarian hyperstimulation syndrome: two distinct entities with different risk factors. Hum Reprod 1994, 9: 792–799.PubMed Lyons CA, Wheeler CA, Frishman GN, Hackett RJ, Seifer DB, Haning RV Jr: Early and late presentation of the ovarian hyperstimulation syndrome: two distinct entities with different risk factors. Hum Reprod 1994, 9: 792–799.PubMed
20.
go back to reference McDonald SD, Han Z, Mulla S, Murphy KE, Beyene J, Ohlsson A, Knowledge Synthesis Group: Preterm birth and low birth weight among in vitro fertilization singletons: a systematic review and meta-analyses. Eur J Obstet Gynecol Reprod Biol 2009, 146: 138–148. 10.1016/j.ejogrb.2009.05.035CrossRefPubMed McDonald SD, Han Z, Mulla S, Murphy KE, Beyene J, Ohlsson A, Knowledge Synthesis Group: Preterm birth and low birth weight among in vitro fertilization singletons: a systematic review and meta-analyses. Eur J Obstet Gynecol Reprod Biol 2009, 146: 138–148. 10.1016/j.ejogrb.2009.05.035CrossRefPubMed
Metadata
Title
Pregnancy outcome in severe OHSS patients following ascitic/plerural fluid drainage
Authors
Jigal Haas
Yoav Yinon
Katya Meridor
Raoul Orvieto
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Journal of Ovarian Research / Issue 1/2014
Electronic ISSN: 1757-2215
DOI
https://doi.org/10.1186/1757-2215-7-56

Other articles of this Issue 1/2014

Journal of Ovarian Research 1/2014 Go to the issue