Ženské hormony a otoky
Cyklické, periodické otoky u žen
- V závislosti na menstruačním cyklu
- Premenstruální otoky [12]
- Spojené často s obezitou či depresí [8]
- Abúzus kličkových diuretik, jež si ženy ordinují samy, situaci jen zhoršuje [9]
- Zadržování sodíku + zvýšená kapilární propustnost pro bílkovinu
Hyperprolaktinemie
- Může zhoršovat pohotovost k cévním prosakům
- Indomethacin completely suppressed the pro-inflammatory effect of ovine PRL
- Bromocriptine reduced the paw oedema
- Both bromocriptine and PRL were administered
- The two opposite effects seem to annual each other
- pubmed.ncbi.nlm.nih.gov/1414693/
Phospholipase A2
- Induced paw oedema was potentiated by PRL pretreatment
- Inhibited by bromocriptine
- pubmed.ncbi.nlm.nih.gov/1414693/
Ovarian hyperstimulation syndrome (OHSS)
- To induce final oocyte maturation and/or trigger oocyte release
- Often in conjunction with IVF [21]
Clomifene citrate therapy
- Can occasionally lead to OHSS
Gonadotropin therapy - FSH
- Vast majority of cases [21]
Pergonal
hCG
- Cca 5% of treated women may encounter moderate to severe OHSS [21]
Risk factors
- Young age,
- Development of many ovarian follicles under stimulation
- Extreme elevated serum estradiol concentrations
- Use of hCG for final oocyte maturation and/or release
- Continued use of hCG for luteal support
- Occurrence of a pregnancy (resulting in hCG production) [21]
Patofyziologie
- HCG causes the ovary to undergo extensive luteinization
- Released large amounts of
- Estrogens,
- Progesterone,
- Local cytokines
- Vascular endothelial growth factor (VEGF) is a key substance that induces vascular hyperpermeability
- Shift of fluids from the intravascular system to the abdominal and pleural cavity [21]
- Supraphysiologic production of VEGF from many follicles under the prolonged effect of hCG
- Specific key process underlying OHSS
- Ascites
- Hypovolemic
- Risk for respiratory, circulatory and renal problems
- Arterial thromboembolism since thicker blood [21]
