ʻO Syndrome hyperstimulation Ovarian

ʻO Ovarian hyperstimulation Syndrome (OHSS) kahi pilikia i ʻike ʻia i kekahi manawa i nā wahine e lawe i nā lāʻau momona e hoʻoulu ai i ka hana hua.

ʻO ka maʻamau, hana ka wahine i hoʻokahi hua manu i kēlā me kēia mahina. ʻO kekahi mau wahine i pilikia i ka hāpai ʻana e hāʻawi ʻia i nā lāʻau e kōkua iā lākou e hana a hoʻokuʻu i nā hua.

Inā hoʻonāukiuki nui kēia mau lāʻau i nā ovaries, hiki i nā ovaries ke hu a nui. Hiki ke kahe i ka wai i loko o ka ʻōpū a me ka umauma. Kāhea ʻia kēia ʻo OHSS. Kū wale kēia ma hope o ka hoʻokuʻu ʻia ʻana o nā hua mai ka ovary (ovulation).

Loaʻa paha iā ʻoe ka OHSS inā:

• Loaʻa iā ʻoe kahi kī o gonadotropin chorionic kanaka (hCG).
• Loaʻa iā ʻoe ma mua o hoʻokahi mahele o ka hCG ma hope o ka hoʻoipoipo.
• Hāpai ʻoe i kēia wā o kēia pōʻaiapuni.

ʻAʻohe laha ʻo OHSS i nā wahine e lawe wale i nā lāʻau hoʻohua ma ka waha.

Hoʻopili ka OHSS i ka 3% i ka 6% o nā wahine e hele i loko o ka vitro fertilization (IVF).

ʻO nā kumu pilikia ʻē aʻe no ka OHSS:

• ʻO ka ʻōpio ma mua o 35 mau makahiki
• Loaʻa i kahi pae estrogen kiʻekiʻe loa i ka wā o nā hoʻoponopono momona
• Loaʻa i ka polycystic ovarian syndrome

Hiki ke kau ʻia nā ʻōuli o OHSS mai ke akahai a i ke koʻikoʻi. ʻO ka hapa nui o nā wahine me ke ʻano loaʻa nā ʻōuli mālie e like me:

• ʻŌpū ʻōpū
• ʻEha ʻeha ma ka ʻōpū
• Kaumaha hoʻonui

I nā hihia maʻamau, hiki i nā wahine ke loaʻa nā hōʻailona koʻikoʻi, e like me:

• Loaʻa kaupaona wikiwiki (ʻoi aku ma mua o 10 paona a i ʻole 4.5 kilokilo i 3 a 5 mau lā)
• ʻOi loa ka ʻeha a i ʻole ka pehu ʻana ma ka ʻōpū
• Hoemi i ka urination
• Pokole o ka hanu
• Nausea, ka luaʻi, a i ʻole ka palahī

Inā loaʻa iā ʻoe kahi hihia koʻikoʻi o OHSS, pono e nānā pono kāu kauka olakino i kāu mau ʻōuli. Hoʻokomo ʻia ʻoe i ka haukapila.

E ana ʻia kou kaupaona a me ka nui o kou ʻōpū (ʻōpū). ʻO nā hoʻāʻo e hana ʻia ana paha:

• ʻO ke ultrasound ʻōpū a i ʻole ke mele ultrasound
• Pākuʻi x-ray
• Helu piha koko
• Panela uila
• Hoʻoikaika hana ate
• Nā hoʻāʻo e ana i ka puka mimi

ʻAʻole pono e mālama maʻamau i nā hihia akahai o OHSS. Hiki i ke kūlana ke hoʻomaikaʻi i nā manawa o ka hāpai ʻana.

Hiki i nā kaʻina hana ke kōkua iā ʻoe e hōʻoluʻolu i kou pilikia.

• E hoʻomaha nui me kou mau wāwae i hāpai ʻia. Kōkua kēia i kou kino e hoʻokuʻu i ka wai. Eia nō naʻe, ʻoi aku ka maikaʻi o ka hana māmā i kēlā me kēia manawa ma mua o ka hoʻomaha o ka moe, ke ʻole ke kauka e haʻi ʻē aʻe iā ʻoe.
• Inu ma kahi o 10 a 12 paha aniani (ma kahi o 1.5 a 2 liters) o ka wai i kēlā lā (keu hoʻi i nā mea inu i loaʻa nā electrolytes).
• Hōʻalo i ka wai ʻona a i ʻole nā ​​inu inu caffeine (e like me colas a kope paha).
• Hōʻalo i ka hoʻoikaika kino a me ka moekolohe. Hiki i kēia mau hana ke kumu i ka hōʻoluʻolu o ovarian a hiki i ke kumu o ka haʻihaʻi ʻana a i ʻole ka puka ʻana o nā cista ovarian, a i ʻole hoʻohuli i nā ovaries a ʻokiʻoki i ke kahe o ke koko (ovarian torsion).
• Lawe i kahi mea hōʻemi ʻeha ma kahi kūʻai e like me ka acetaminophen (Tylenol).

Pono ʻoe e kaupaona iā ʻoe iho i kēlā me kēia lā e hōʻoia ʻaʻole ʻoe e kau ana i ka nui o ka paona (2 a ʻoi paona a i ʻole ma kahi o 1 kilokika a ʻoi aku i ka lā).

Inā kuhi kāu mea hāʻawi i ka OHSS koʻikoʻi ma mua o ka hoʻoili ʻana i nā embryos i kahi IVF, hoʻoholo paha lākou e hoʻopau i ka lawe ʻana i ka embryo. Paʻahau nā embryo a kali lākou i ka OHSS e hoʻonā ma mua o ka hoʻonohonoho ʻana i kahi pōʻai hoʻololi hoʻohuli embryo paʻahau.

I kahi hihia maʻamau e hoʻomohala ʻoe i kahi OHSS koʻikoʻi, pono paha ʻoe e hele i kahi haukapila. Hāʻawi ka mea hāʻawi iā ʻoe i nā wai ma o kahi aa (nā wai i loko o ke kino). Lawe pū lākou i nā wai i hōʻiliʻili i loko o kou kino, a nānā i kou ʻano.

ʻO ka hapa nui o nā hihia ʻoluʻolu o OHSS e haʻalele iā lākou iho ma hope o ka hoʻomaka ʻana o ka menstruation. Inā loaʻa iā ʻoe kahi hihia ʻoi aku ka koʻikoʻi, hiki ke hala i mau lā no ka hoʻomaikaʻi ʻana o nā ʻōuli.

Inā hāpai ʻoe i ka wā o OHSS, hiki i nā ʻōuli ke piʻi aʻe a hiki ke hala i mau hebedoma e hele aku ai.

I nā hihia maʻamau, hiki i ka OHSS ke alakaʻi i nā pilikia make. Hiki i kēia mau mea ke:

• Huʻi koko
• Hewa ʻole nā ​​hakuʻala
• ʻO ke kaulike uila ʻole
• ʻO ka paʻa ʻana o ka wai i loko o ka ʻōpū a i ʻole ka umauma

Kāhea i kāu mea hāʻawi inā ʻike ʻoe i kekahi o nā hōʻailona aʻe:

• ʻOi aku ka liʻiliʻi o ka mimi
• Puʻupuʻu
• Loaʻa kaupaona nui, ʻoi aku ma mua o 2 paona (1 kg) i ka lā
• Nualua maikaʻi ʻole (ʻaʻole hiki iā ʻoe ke mālama i ka meaʻai a i ʻole nā ​​wai i lalo)
• ʻEha ʻeha loa
• Pokole o ka hanu

Inā loaʻa iā ʻoe nā injection o nā lāʻau lapaʻau momona, pono ʻoe e loaʻa i nā hoʻokolohua koko maʻamau a me nā pelvic ultrasounds e hōʻoia i ka pane ʻole o kāu ovaries.

OHSS

ʻO Catherino WH. Reproductive endocrinology a me ka infertility. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier Saunders; 2020: chap 223.

Fauser BCJM. Nā lāʻau lapaʻau e hoʻokokoke i ka ovarian stimulate no ka hānau ʻole. I: Strauss JF, Barbieri RL, eds.ʻO Yen & Jaffe's Reproductive Endocrinology. 8th ed. Piladelapia, PA: Elsevier; 2019: chap 30.

Lobo RA. Infertility: etiology, diagnostic loiloi, hoʻokele, wānana. I: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Gynecology Comprehensive. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 42.