Clinical scenario

Severe OHSS with haemoconcentration and dehydration requires hospital admission. Complications can include pleural effusion and large volumes of abdominal fluid requiring procedural intervention. Structured inpatient management aims to reverse these changes and restore physiological balance.

Treatment approach

Management centres on structured inpatient supportive care, with fluid balance management as the primary clinical priority. Further interventions address pain, thromboprophylaxis, and complications as guided by clinical response. The complete regimen — including agent selection, sequencing, and clinical thresholds — is in the protocol.

References

DOI: 10.1111/1471-0528.70195

Acutely dehydrated women may need intravenous fluid therapy to correct fluid balance, followed by oral fluids to maintain hydration.
Crystalloids are useful for the initial correction of dehydration in women who are unable to maintain adequate oral intake.
Human albumin solution 20% may be used as a plasma volume expander in doses of 50–100 g (100 mL), infused over 4 h and can be repeated 4 to 12 hourly as required.
Analgesia with paracetamol and opiates, if required, is appropriate, while NSAIDs should be avoided as they may compromise renal function.
Some women may need effective analgesia and antiemetics to maintain adequate fluid balance.
Women admitted to hospital with OHSS should be prescribed anti-embolism stockings and receive LMWH prophylaxis.
Paracentesis should be carried out under ultrasound guidance and can be performed abdominally or vaginally.
Intravenous colloid therapy should be considered when large volumes of fluid have been removed by paracentesis.
A chest drain may be required if ongoing symptoms related to pleural effusion.

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Inpatient Treatment of Severe Ovarian Hyperstimulation Syndrome

Clinical scenario

Treatment approach

Recovery targets

References