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What monitoring parameters are essential for a patient diagnosed with OHSS during their treatment?
Answer
Essential monitoring parameters for a patient diagnosed with ovarian hyperstimulation syndrome (OHSS) during treatment include close clinical and biochemical assessment to detect severity and complications early. Ultrasound monitoring is critical to assess ovarian size, follicular number, and the presence of ascites, which helps guide management and prevent progression of OHSS. Regular measurement of fluid balance including input and output is necessary to monitor for third spacing and risk of hypovolemia or fluid overload. Vital signs such as blood pressure, heart rate, respiratory rate, and oxygen saturation should be frequently monitored to detect hemodynamic instability or respiratory compromise. Laboratory tests should include haematocrit and full blood count to assess haemoconcentration and risk of thrombosis, renal function tests (urea, creatinine) to monitor for renal impairment, and electrolytes to detect imbalances. Monitoring serum electrolytes and coagulation profile is important due to the risk of thromboembolism and electrolyte disturbances. Weight monitoring daily is advised to detect rapid weight gain from fluid accumulation. Patient symptoms such as abdominal pain, nausea, vomiting, and dyspnoea should be regularly assessed to evaluate clinical progression. These parameters collectively guide the intensity of treatment and the need for hospital admission or intervention 1 (Chen et al., 2011).
UK guidelines emphasize the use of ultrasound monitoring during ovarian stimulation to reduce the risk of OHSS and multiple pregnancy, which extends to monitoring patients diagnosed with OHSS to track ovarian response and fluid accumulation 1. The literature supports this by highlighting the importance of early detection of complications through clinical and laboratory monitoring to prevent severe outcomes (Chen et al., 2011). Thus, an integrated approach combining clinical assessment, ultrasound, fluid balance, vital signs, and laboratory investigations forms the cornerstone of monitoring in OHSS management.
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