Ovarian Hyperstimulation Syndrome in Spontaneous Pregnancy

Does the COVID-19 pandemic have an impact on fears and concerns among pregnant women?

Zabochnicki M et al., 2024 · Annales Academiae Medicae Silesiensis · Free to read

Wprowadzenie Objawy lękowe i depresyjne są powszechnymi objawami w okresie ciąży. Wystąpienie pandemii wirusa COVID-19 jest wyjątkowym stresorem, który wpłynął na psychologiczny aspekt przebiegu porodu. Celem pracy jest ocena wpływu pandemii COVID-19 na przebieg ciąży i porodu w populacji polskiej. Materiał i metody Grupę badawczą stanowiło 2186 kobiet. Badanie ankietowe zostało przeprowadzone w okresie od listopada 2020 r. do grudnia 2020 r. za pośrednictwem Internetu. Kryterium włączenia do badania były ciąża i poród w okresie pandemii COVID-19. Do oceny stopnia poziomu strachu i obaw wykorzystano pytania stworzone przez autorów z zastosowaniem pięciostopniowej skali Likerta. Wyniki U kobiet hospitalizowanych w czasie ciąży występował większy poziom strachu i obaw związanych z ciążą (średnia 30,9 vs 29,6; p = 0,007). Podobną zależność stwierdzono w przypadku kobiet, u których wykonano cesarskie cięcie (30,6 vs 29,5; p = 0,006) lub które były hospitalizowane > 7 dni (31,8 vs 29,7; p = 0,012). Stwierdzono również istotną statystycznie, choć słabą korelację pomiędzy średnimi wynikami pytań dotyczących obaw a liczbą hospitalizacji w czasie ciąży (współczynnik korelacji Pearsona r = 0,1654; p < 0,000). Wnioski Badanie wykazało alarmująco wysoki poziom lęku u kobiet w ciąży podczas pandemii COVID-19, co może mieć długoterminowe konsekwencje dla ich dzieci.

Diagnostic utility of translabial ultrasound in pelvic organ prolapse: a prospective observational study

Pietrus M et al., 2024 · Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology · Free to read

The increasing awareness of women's health issues, specifically pelvic organ prolapse (POP) and urinary incontinence (UI), has spurred a surge in patients seeking specialised advice for these conditions, necessitating modern diagnostic approaches for such issues. This study explored the diagnostic utility of translabial ultrasound for POP, emphasising its correlation with clinical assessments based on International Continence Society (ICS) criteria. Seventy-one patients with POP Quantification System (POP-Q) stage 0-IV with or without UI were prospectively enrolled at Jagiellonian University Medical College between 2014 and 2016. The study objectives included evaluating diagnostic accuracy and concordance across pelvic compartments, correlating the diagnoses with patient-reported symptoms, and identifying variables contributing to diagnostic discrepancies. Translabial ultrasound identified POP in 74.5% of the patients, aligning closely with clinical evaluations. Concordance was the highest in assessments performed in the medial compartment (85.8%), while assessments performed in the anterior (29.6%) and posterior (29.6%) compartments showed higher rates of discrepancies. Correlation analyses showed varying associations, with the posterior compartment exhibiting the least pronounced correlation (R = 0.72, p < 0.0001). Self-perceive POP showed no discernible differences in relation to ultrasonographic and clinical assessments. Among the respondents, 55.9% reported experiencing the sensation of POP. Mean POP levels determined using the two approaches precisely matched in 46.5% of these cases. Discrepancies involved variables such as self-perceived POP, number of deliveries, child weight at birth, UI, and sexual activity. Translabial ultrasound showed robust correlation with clinical assessments for evaluating POP, especially for defining defects and facilitating treatment-related decision-making. Our findings highlight the reliability of this method, particularly for assessments in the medial compartment. The evidence did not indicate the superiority of either method in detecting POP disorders for symptomatic versus asymptomatic patients. Significantly, a higher POP-Q measurement in clinical examination was correlated with greater sexual activity.

Does the COVID-19 Pandemic Affect Labor-Related Anxiety and Prevalence of Depressive Symptoms in Pregnant Women?

Wikarek A et al., 2022 · Journal of clinical medicine · Free full text on PubMed Central

The COVID-19 pandemic undoubtedly had significant effects on women's health and the course of pregnancy. The aim of this single-center study was to explore the impact of the COVID-19 pandemic on adult pregnant and postpartum women's mental health, as well as to identify factors associated with depressive symptoms, anxiety and fear of delivery. The 465 women included in this questionnaire-based cohort study were divided into two groups: one (controls) of women who gave birth before (n = 190), and the second who were pregnant and delivered during the pandemic (n = 275). The COVID-19 pandemic affected the severity of self-reported anxiety regarding childbirth (mean scores 2.7 vs. 2.36, p = 0.01). The depression (19.84 ± 13.23) and anxiety (16.71 ± 12.53) scores were higher in pregnant women during the COVID 19 pandemic, compared to women who gave birth before the pandemic (8.21 ± 7.38 and 11.67 ± 9.23, respectively). These findings demonstrate the magnitude of the pandemic's impact on women's mental health, and actions to improve the mental health of pregnant women in Poland may be crucial for maternal and fetal well-being.

A 36-year-old pregnant woman with hyperimmunoglobulinemia E

Matyja MK et al., 2022 · Ginekologia polska · Free to read

Ovarian hyperstimulation syndrome after assisted reproductive technologies: trends, predictors, and pregnancy outcomes

Schirmer DA 3rd et al., 2020 · Fertility and Sterility · Free full text on PubMed Central

To assess trends, predictors, and perinatal outcomes of ovarian hyperstimulation syndrome (OHSS) associated with in vitro fertilization (IVF) cycles in the United States. Retrospective cohort study using National Assisted Reproductive Technology Surveillance System (NASS) data. Not applicable. PATIENT(S): Fresh autologous and embryo-banking cycles performed from 2000 to 2015. INTERVENTIONS(S): None. MAIN OUTCOME MEASURE(S): OHSS, first-trimester loss, second-trimester loss, stillbirth, low birth weight, and preterm delivery. RESULT(S): The proportion of IVF cycles complicated by OHSS increased from 10.0 to 14.3 cases per 1,000 from 2000 to 2006, and decreased to 5.3 per 1,000 from 2006 to 2015. The risk of OHSS was highest for cycles with more than 30 oocytes retrieved (adjusted risk ratio [aRR] 3.85). OHSS was associated with a diagnosis of ovulatory disorder (aRR 2.61), tubal factor (aRR 1.14), uterine factor (aRR 1.17) and cycles resulting in pregnancy (aRR 3.12). In singleton pregnancies, OHSS was associated with increased risk of low birth weight (aRR 1.29) and preterm delivery (aRR 1.32). In twin pregnancies, OHSS was associated with an increased risk of second-trimester loss (aRR 1.81), low birth weight (aRR 1.06), and preterm delivery (aRR 1.16). CONCLUSION(S): Modifiable predictive factors for OHSS include number of oocytes retrieved, pregnancy following fresh embryo transfer, and the type of medication used for pituitary suppression during controlled ovarian hyperstimulation. Patients affected by OHSS had a higher risk of preterm delivery and low birth weight. Clinicians should take measures to reduce the risk of OHSS whenever possible.

Ovarian Hyperstimulation Syndrome: A Narrative Review of Its Pathophysiology, Risk Factors, Prevention, Classification, and Management

Namavar Jahromi B et al., 2018 · Iranian journal of medical sciences

Ovarian hyperstimulation syndrome (OHSS) is a serious complication of ovulation induction that usually occurs after gonadotropin stimulation, followed by human chorionic gonadotropin administration, for infertility treatment. The existing knowledge about the pathophysiology, risk factors, and primary and secondary methods for the prevention of OHSS is reviewed in this manuscript. The clinical manifestations and characteristics of mild, moderate, severe, and critical forms of the syndrome are defined. The methods of handling affected cases as outpatient or in-hospital management methods as well as indications for hospitalization are summarized in this review. The clinical and biochemical routes of assessing and monitoring hospitalized patients with OHSS, various drugs and medical treatment strategies including indications for aspiration of the ascitic fluid and pleural effusion, and also rare indications for surgery are briefly explained in this article. Severe OHSS, which two decades ago was considered an iatrogenic life-threatening condition, can now be effectively prevented or managed during the early stages. An OHSS-free clinic can be established nowadays by carefully considering the endocrinology of ovulation and using appropriate and dose-adjusted pharmaceutical agents, which are summarized and discussed in this review.

Annual incidence of severe ovarian hyperstimulation syndrome

Tomás C et al., 2021 · Danish Medical Journal

Ovarian hyperstimulation syndrome (OHSS) is one of the major complications of assisted reproductive technology treatment. We assumed that it had declined in recent years owing to the options of new preventive strategies. The aim of the present study was to investigate the annual incidence of OHSS in Denmark in the course of a 17-year period. This was a national register-based historical cohort study including all women with an OHSS diagnosis admitted to Danish hospitals between 2001 and 2017. Data included information on all OHSS diagnoses, duration of hospital stay, early pregnancy complications and other complications like thromboembolism and ovarian torsion. The annual number of initiated stimulated in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) cycles was based on the annual reporting by the Danish Fertility Society. From 2001 to 2017, a total of 2,261 (1.2%) women with an OHSS admission were identified among 186,168 stimulated IVF/ICSI cycles. The annual incidence of OHSS varied from 0.9% to 1.2-1.4% with no overall change over time (p = 0.24. Early OHSS (defined as OHSS without a pregnancy in the cycle) was seen in 48.5% of the events, late OHSS (defined as OHSS with a pregnancy in the cycle) in 51.2% of cycles. Among all women with OHSS, 75% were hospitalised for more than 24 hours, with mean 4.3 and 6.2 days in hospital for early and late OHSS, respectively. The annual incidence of severe OHSS leading to a hospital admission remained stable for 17 years, which suggests that OHSS preventive actions like use of antagonist cycles, agonist triggering and freeze all should be better implemented in Denmark. none. not relevant.

Prevention of moderate and severe ovarian hyperstimulation syndrome: a guideline

Practice Committee of the American Society for Reproductive Medicine, 2024 · Fertility and Sterility

Ovarian hyperstimulation syndrome is a serious complication associated with assisted reproductive technology. This systematic review aims to identify who is at high risk for developing ovarian hyperstimulation syndrome, along with evidence-based strategies to prevent it and replaces the document of the same name last published in 2016.