| Clinical features | Biochemical features |
Mild | - Abdominal distention/discomfort
- Mild nausea/vomiting
- Diarrhea
- Enlarged ovaries
| - No clinically important laboratory findings
|
Moderate | - Presence of mild features plus:
- Ultrasonographic evidence of ascites
| - Elevated Hct (>41%)
- Elevated WBC (>15,000/microL)
- Hypoproteinemia
|
Severe | - Presence of mild and moderate features plus:
- Clinical evidence of ascites (can be tense ascites)
- Severe abdominal pain
- Intractable nausea and vomiting
- Rapid weight gain (>1 kg in 24 hours)
- Pleural effusion
- Severe dyspnea
- Oliguria/anuria
- Low blood/central venous pressure
- Syncope
- Venous thrombosis
| - Hemoconcentration (Hct >55%)
- WBC >25,000/microL
- Serum creatinine >1.6 mg/dL
- Creatinine clearance <50 mL/min
- Hyponatremia (Na+ <135 mEq/L)
- Hyperkalemia (K+ >5 mEq/L)
- Elevated liver enzymes
|
Critical | - Presence of severe features plus:
- Anuria/acute renal failure
- Arrhythmia
- Pericardial effusion
- Massive hydrothorax
- Thromboembolism
- Arterial thrombosis
- ARDS
- Sepsis
| - Worsening of biochemical findings seen with severe OHSS
|