Ovarian hyperstimulation syndrome and intra-abdominal hypertension: a systematic review

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OBJECTIVE

To summarize and analyze modern data on the role of intra-abdominal hypertension (IAH) in ovarian hyperstimulation syndrome (OHSS).

MATERIAL AND METHODS

A systematic review included clinical trials, meta-analyses, reviews and case reports devoted to IAH in OHHS. We reviewed the MedLine PubMed (between 1966 and June 2023), Cochrane Controlled Clinical Trials Register and Embase databases (until June 2023).

RESULTS

Moderate, severe and critical OHSS is accompanied by increased intra-abdominal volume and IAH. The main factors of IAH are ovarian enlargement and progression of ascites. Uncontrolled IAH in OHSS leads to multiple organ failure and abdominal compartment syndrome in case of untimely paracentesis/culdocentesis. Most reports devoted to OHSS have no data on IAP.

CONCLUSION

A systematic review supports the hypothesis of potential role of IAH in severe OHSS and poor outcomes. One should consider IAH grade in management of patients with OHSS. Current evidence suggests that early paracentesis/culdocentesis is advisable to reduce IAP and prevent progression of OHSS. Further studies are needed to confirm these findings.

Keywords:

ovarian hyperstimulation syndrome

complications of ovarian hyperstimulation syndrome

intra-abdominal pressure

intra-abdominal hypertension

abdominal compartment syndrome

systematic review

Authors:

Petrenko A.P.

Razumovsky Saratov State Medical University;
Gordeev Saratov City Clinical Hospital No. 1

ORCID: 0000-0003-1035-8025

Shifman E.M.

Vladimirsky Moscow Regional Research Clinical Institute;
Pirogov Russian National Research Medical University

SPIN RSCI: 4582-8494
Scopus AuthorID: 6507655298
ResearcherID: AAY-3981-2020
ORCID: 0000-0002-6113-8498

Castelo-Branco C.

Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine-University of Barcelona, Hospital Clinic — Institut d´Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)

ORCID: 0000-0002-9860-8318

Marshalov D.V.

Razumovsky Saratov State Medical University

ORCID: 0000-0002-8774-0700

Kuligin A.V.

Razumovsky Saratov State Medical University

ORCID: 0000-0001-5705-215X

Nesnova E.S.

Razumovsky Saratov State Medical University;
Gordeev Saratov City Clinical Hospital No. 1

ORCID: 0000-0001-6660-0998

Received:

19.11.2023

Accepted:

28.12.2023

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