Intra-venous fluids for preventing severe ovarian hyperstimulation syndrome (OHSS)

Intra-venous plasma expanders (human albumin, hydroxyethyl starch and mannitol) might be effective for prevention of moderate and severe ovarian hyperstimulation syndrome in women at high risk. compared to placebo. Hydroxyethyl starch and mannitol might not effect pregnancy rates while human albumin may reduce pregnancy rates. However, there were no data on live birth rates.

Comment: The quality of evidence is downgraded by study limitations (poor reporting and failure to blind outcome assessment), by imprecision (wide confidence intervals and few outcome events), and by indirectness (no data on live birth).

A Cochrane review included 9 RCTs involving 1 867 high-risk women undergoing ovarian hyperstimulation. There was a decrease in the incidence of severe ovarian hyperstimulation syndrome (OHSS) with administration of human albumin, hydroxyethyl starch (HES) or mannitol compared to placebo or no treatment2=62%; 8 studies). There was a statistically significant decrease in severe OHSS incidence with administration of hydroxyethyl starch (OR 0.12, 95% CI 0.04 to 0.40; 3 studies)"?> (table ). There was no evidence of statistical difference in the pregnancy rate wtih mannitol or HES, but a clear decrease with human albumin (table ). There were no data on live birth rate. Adverse effects were rare.

Ədəbiyyat

1. Youssef MA, Al-Inany HG, Evers JL, Aboulghar M. Intra-venous fluids for the prevention of severe ovarian hyperstimulation syndrome. Cochrane Database Syst Rev 2011;(2):CD001302 [Assessed as up-to-date: 2 September 2015]. .