Volume 3 Supplement 1

19th International Symposium on Intensive Care and Emergency Medicine

Open Access

Ovarian hyperstimulation syndrome (OHSS) at a maternity hospital

  • V Lappas1,
  • P Myrianthefs1,
  • C Ladakis1,
  • S Pactitis1,
  • A Carousou1,
  • J Stamatiou1 and
  • G Baltopoulos1
Critical Care20003(Suppl 1):P234

DOI: 10.1186/cc607

Published: 16 March 2000


Ovarian hyperstimulation syndrome (OHSS) is a clinically important entity due to assisted conception which occurs in about 1-10% of in vitro fertilization (IVF) cycles with serious complications such as deep vein thrombosis, hypovolaemia, haemorrhage, respiratory distress and hepato-renal failure.


The aim of this study was to describe our experience with OHSS at 'IASO' Maternity Hospital.

Materials and methods

The last year seven patients with age 30 ± 2.4 (X ± SEM) were admitted in our ICU due to severe ovarian hyperstimulation syndrome complications.


Signs and symptoms (Table 1) and labs (Table 2) were due to third space fluid shift (increased capillary permeability) with evidence of hypovolaemia, haemoconcentration and dehydration.

Ultrasound examination of the abdomen showed ascites, pelvic fluid and enlarged ovaries (in our patients > 11 cm in diameter) in all patients and chest X-ray revealed hydrothorax in five patients (71%). Ovarian hyperstimulation syndrome clinical feature is due to exaggerated ovarian response characterized by marked elevation of serum oestradiol levels and the presence of a large number of follicles (>20).

Management and outcome

All patients had bed rest, fluid input-output control, adequate fluid intake, high protein oral intake, human albumin solutions iv and LMWH sc (nadroparin calcium 3000 iu). Two patients had paracentesis of hydrothorax because of dyspnea or discomfort. Hospital and ICU stay was 8 ± 3.3 and 5 ± 1.9 days, respectively. All patients recovered without developing any life threatening complications and were discharged in good condition.

Conclusions and discussion

Ovarian hyperstimulation syndrome is a serious clinical condition [1] which may be complicated by life threatening events in up to 0.5-2% [1,2]. Early recognition and management until normalization of oestradiol serum levels provide good outcome with mortality rate 0.0025% [1].
Table 1.

Signs and symptoms on admission

Generalized edema




Weight gain


Chest discomfort


Thirst sensation






Abdominal distension or pain




Table 2.

Labs on admission and discharge





(X ± SEM)

(X ± SEM)

Ht (%)

45 ± 1.97

33 ± 1.67

Na+ (mmol/l)

133 ± 1.02

138 ± 1.29

Urea (mg/dl)

42 ± 4.6

32 ± 1.8

Alb (g/dl)

2.8 ± 0.12

4.25 ± 0.31

WBC × 103/µl

16.4 ± 1.35

10.7 ± 1.54

Oestradiol (pg/dl)

4735 ± 1658


Authors’ Affiliations

Department of Intensive Care Unit of `IASO' Maternity Hospital at Athens, Athens University School of Nursing Intensive Care Unit at `Agioi Anargyroi' Cancer Hospital of Kifissia


  1. Brindsen PR, Wada I, Tan SL, Balen A, Jacobs HS: Diagnosis, prevention and management of ovarian hyperstimulation syndrome. Br J Obstet Gynaecol 1995, 102: 767-772.View ArticleGoogle Scholar
  2. Schenker JG, Weinstein D: Ovarian hyperstimulation syndrome: a current survey. Fertil Steril 1978, 30: 255-268.PubMedGoogle Scholar


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