Over Hiperstimülasyon Sendromu ve Ebelik Yaklaşımı

Yıl 2025, Cilt: 6 Sayı: 3, 583 - 595, 31.12.2025

Şilan Yavuz , Yasemin Hamlacı Başkaya

https://doi.org/10.59244/ktokusbd.1771907

Öz

Overlerin kontrollü stimülasyonundan sonra ortaya çıkan ve kadın yaşamı için son derece kritik olabilen over hiperstimülasyon sendromu, çoğunlukla yardımcı üreme tekniklerinin bir sonucudur. Overlerin, stimülasyona aşırı yanıt vermesi sonucunda ortaya çıkan bu sendrom, luteal fazda veya gebeliğin erken dönemlerinde ortaya çıkmaktadır. Zorunlu bir raporlama ve standart bir sınıflama sisteminin bulunmaması nedeniyle gerçek OHSS insidansı bilinmemektedir. Sendromun gelişip gelişmeyeceğini öngörmek için bazı risk faktörleri belirlenmiştir. Bu risk faktörlerinin bir kısmı 30 yaşın altında olmak, yüksek beden kütle indeksi, çoğul gebelik, polikistik over sendromuna sahip olmak, yüksek antral folikül sayısı, artmış antimüllerian hormon düzeyi, artmış serum estradiol 2 düzeyine sahip olmak şeklinde sıralanabilir. Genellikle en geç üç haftalık bir sürede düzelme beklense de semptomların üç aya kadar sürdüğünü bildiren vaka raporları mevcuttur. Sendroma ilişkin semptomlar bulantı, kusma, abdominal şişkinlik ve ağrı, abdomende sıvı birikmesi, dehidratasyon, oligüri, plevral efüzyon, nefes darlığı, tromboembolidir. OHSS görülen bu semptomlara göre hafif, orta, şiddetli olmak üzere sınıflandırılmakta iken OHSS’nin dört tipini içeren modifiye bir sınıflama sistemi de bulunmaktadır. Ultrasonografi aracılığıyla tanılanan OHSS’nin tedavisinde amaç semptomları gidermek ve olası komplikasyonları önlemektir. Kadınları ve ailelerini son derece etkileyen bu sendromun anksiyete, umutsuzluk gibi psikolojik etkileri de bulunmaktadır. Tüm bu fizyopatolojik ve psikolojik semptomlar yaşanırken ebeler kadınlara danışmanlık ve rehberlik sağlayıcı, bakım verici, destekleyici, savunucu rolleri ile ebelik bakım hizmeti sunmaktadır. Bu derlemede amaç, over hiperstimülasyon sendromunu güncel literatür ışığında gözden geçirmek ve kadınların bu süreçte ihtiyaç duydukları ebelik bakımına yönelik bilgi sağlamaktır.

Anahtar Kelimeler

Over hiperstimülasyon sendromu , ovarian stimülasyon , ebelik

Kaynakça

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