Predictive Factors For Recovery Time In 117 Patients Suffering From Severe OHSS

Objective:To evaluate predictive factors for recovery time from severe ovarian hyperstimulation syndrome(OHSS).Methods:In a retrospective cohort study,117 women who were hospitalized for severe ovarian hyperstimulation syndrome were included.The patients were selected from gynecological department of the second hospital of Hebei Medical University since January 2010 to December 2018.All the patients received standardized treatment including intravenous hydration,plasma volume expansion,maintaining fluid and electrolyte balance,human albumin,subcutaneous heparin,and paracentesis if necessary.The crucial outcome parameter was recovery time from OHSS.Recovery was defined if the patient had not suffered from obvious abdominal pain and discomfort,hematocrit<40%,Rebalance of fluid and electrolytes,and complete biochemical remission.Patients were divided into pregnant group and nonpregnant group.The generalized linear model was used to analyze the baseline data,assisted reproductive process and clinical items of the two groups to explore the predictors of the recovery time.Results:1.Pregnant patients(n = 46,39.3%)revealed a longer median duration until recovery than non-pregnant patients(n = 71,60.7%;9.00 days,IQR 5.00-14.25,vs.5.00 days,IQR 4.00-8.00,Respectively;P = 0.001).2.Univariate analyses demonstrated that protocol(P = 0.001),serum level of estrone(P < 0.001),serum albumin levels(P = 0.002),WBC(P = 0.039)were associated with a longer recovery time in pregnant patients.While,in non-pregnant patients,number of large and medium follicles(P = 0.038)was associated with a longer recovery time.3.In a generalized linear model,protocol(?=-0.635±0.2075,P=0.002),serum level of estrone(?=0.265±0.0897,P=0.003)and number of abdominal paracentesis(?=0.094±0.0462,P=0.043)were associated with a longer recovery time in pregnant patients.In non-pregnant patients,number of large and medium follicles(?=0.127±0.0637,P=0.046)and number of abdominal paracentesis(?=0.167±0.0597,P=0.005)was associated with a longer recovery time.Conclusions:1.Compared with nonpregnant patients,it took a significantly longer recovery time for pregnant patients with serve OHSS.2.In pregnant patients,protocol,serum level of estrone and number of abdominal paracentesis were associated with longer recovery times.In nonpregnant patients,number of large and medium follicles and number of abdominal paracentesis were associated with a longer recovery time.