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master's thesis
Medikamentozno liječenje sindroma hiperstimulacije jajnika
Zagreb: University of Zagreb, School of Medicine, 2017. urn:nbn:hr:105:437738
Galic, Jelena
University of Zagreb
School of Medicine
Department of Gynecology and Obstetrics

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

Cite this document

Galic, J. (2017). Medikamentozno liječenje sindroma hiperstimulacije jajnika (Master's thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:437738

Galic, Jelena. "Medikamentozno liječenje sindroma hiperstimulacije jajnika." Master's thesis, University of Zagreb, School of Medicine, 2017. https://urn.nsk.hr/urn:nbn:hr:105:437738

Galic, Jelena. "Medikamentozno liječenje sindroma hiperstimulacije jajnika." Master's thesis, University of Zagreb, School of Medicine, 2017. https://urn.nsk.hr/urn:nbn:hr:105:437738

Galic, J. (2017). 'Medikamentozno liječenje sindroma hiperstimulacije jajnika', Master's thesis, University of Zagreb, School of Medicine, accessed 24 December 2024, https://urn.nsk.hr/urn:nbn:hr:105:437738

Galic J. Medikamentozno liječenje sindroma hiperstimulacije jajnika [Master's thesis]. Zagreb: University of Zagreb, School of Medicine; 2017 [cited 2024 December 24] Available at: https://urn.nsk.hr/urn:nbn:hr:105:437738

J. Galic, "Medikamentozno liječenje sindroma hiperstimulacije jajnika", Master's thesis, University of Zagreb, School of Medicine, Zagreb, 2017. Available at: https://urn.nsk.hr/urn:nbn:hr:105:437738

Metadata
TitleMedikamentozno liječenje sindroma hiperstimulacije jajnika
Title (english)Medical treatment of ovarian hyperstimulation syndrome
AuthorJelena Galic
MentorMiro Kasum (mentor)
Committee memberMarina Šprem Goldštajn (predsjednik povjerenstva)
Committee memberDinka Pavičić-Baldani (član povjerenstva)
Committee memberMiro Kasum (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
(Department of Gynecology and Obstetrics)
Zagreb
Defense date and country2017-07-14, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Gynecology and Obstetrics
Abstract
Ovarijski hiperstimulacijski sindrom (OHSS) najozbiljnija je jatrogena komplikacija stimulacije ovulacije u postupku medicinski pomognute oplodnje (MPO) do koje dolazi u lutealnoj fazi ciklusa ili u ranoj trudnoći. Sindrom najčešće nastaje nakon primjene egzogenih gonadotropina ili rjeđe klomifena. Karakteriziran je pomakom tekućine iz intravaskularnog u treći prostor te posljedičnom hemokoncentracijom i nakupljanjem tekućine u trbušnoj šupljini, a rjeđe u perikardijalnom i pleuralnom prostoru. Ovisno o laboratorijskim i kliničkim značajkama, dijeli se na blagi, umjereni i teški stadij. Teži se konzervativnom liječenju jatrogene hiperstimulacije te je ono prilagođeno težini sindroma. Prioritetno je održavanje adekvatnog intravaskularnog volumena s ciljem osiguravanja odgovarajuće perfuzije vitalnih organa. Ako to oklonosti dopuštaju, preporučljivo je korištenje oralnog puta unosa tekućine u pacijentica s blagim i umjerenim oblikom sindroma, dok pacijentice s teškim oblikom sindroma iziskuju intravaskularnu nadoknadu tekućine te se u spomenutu svrhu koriste kristaloidne otopine i plazma ekspanderi. Primjena diuretika može se razmotriti tek nakon što se postigao adekvatni intravaskularni volumen te joj je nužno pristupiti sa značajnim oprezom. Ako dođe do razvoja elektolitnih poremećaja, prvenstveno hiponatremije i hiperkalijemije, nužna je njihova korekcija. Tromboprofilaksa se treba razmotriti u pacijentica s umjerenim i teškim oblikom bolesti. Novije terapijske mogućnosti uključuju upotrebu dopamina i dopaminskih agonista, zatim reinicijaciju GnRH antagonista u lutealnoj fazi te smanjenje rizika tromboze povezane sa sindromom upotrebom inhibitora aromataze.
Abstract (english)
The ovarian hyperstimulation syndrome (OHSS) is the most severe iatrogenic complication of ovarian stimulation occurring during the luteal phase or during early pregnancy. It usually develops after the use of exogenous gonadotropins or, less frequently, clomiphene citrate. It is characterized by a fluid shift from the intravascular space to third space compartments and the consequent hemoconcentration and accumulation of fluid in the abdominal cavity or, in fewer cases, in the pericardial and pleural space. Prevention and early recognition of OHSS are essential in maintaining patient's safety. Conservative management of OHSS is preferable and it is adapted depending on the level of its severity. Maintaining an adequate intravascular volume must remain the first priority in order to ensure proper perfusion of vital organs. It is advisable to use the oral route of fluid replacement in a mild to moderate form of OHSS, while patients with severe OHSS require intravascular fluid management using crystalloid fluids and plasma expanders. The use of diuretics can only be considered after an adequate intravascular volume has been achieved and it is necessary to approach it with considerable caution. If patients present electrolyte imbalance, primarily hyponatremia and hyperkalemia, appropriate correction is necessary. Thromboprophylaxis should be considered in patients with moderate to severe OHSS. Newer therapeutic options encompass the use of dopamine and dopamine agonists, the reinstitution of GnRH antagonists in the luteal phase and the reduction of thrombosis-related risk associated with OHSS using aromatase inhibitors.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:437738
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2018-03-23 10:42:06