Aggressive Outpatient Treatment of Ovarian Hyperstimulation Syndrome with Ascites Using Transvaginal Culdocentesis and Intravenous Albumin Minimizes Hospitalization

Patients with severe ovarian hyperstimulation syndrome can be managed safely with aggressive outpatient transvaginal paracentesis

“…They found that outpatient transabdominal paracentesis produced prompt symptom relief and effectively avoided inpatient care. Transvaginal paracentesis combined with IV administration of crystalloid and albumin also has been demonstrated to be a safe and effective strategy in the management of patients with moderate to severe OHSS (22,23). Going even one step further, several reports have described the use of an indwelling transabdominal pigtail catheter placement for continuous drainage of ascites fluid in patients with OHSS, and one group reported the use of outpatient transabdominal percutaneous catheter drainage in patients with severe OHSS (35)(36)(37).…”

“…Others recommend the addition of inpatient paracentesis to IV rehydration to drain ascites fluid in select cases of severe discomfort, pulmonary compromise, or renal compromise not responding to conservative management (20,21). Still others assert that outpatient paracentesis can be used to minimize or avoid hospitalization altogether (22,23).…”

Management of ovarian hyperstimulation syndrome. Produced on behalf of the BFS Policy and Practice Committee

“…Pregnant patients with OHSS should be monitored more closely and for longer as there is an increased risk of progressing to more severe disease under the infl uence of endogenous hCG. Several retrospective studies have described outpatient management of women with severe OHSS, including aggressive paracentesis and fl uid therapy (Shrivastav et al, 1994;Fluker et al, 2000;Lincoln et al, 2002). A retrospective study involving 183 patients with OHSS found that outpatient transvaginal paracentesis was associated with a signifi cant reduction in the number of patients requiring hospitalization.…”

Hyperstimulation ovarienne : place de la chirurgie

“…La ponction peut être réitérée selon l'évolution clinique et la tolé-rance de la patiente. Elle peut être effectuée en ambulatoire [29]. Le moment où la ponction-drainage doit être indiquée est sujet à débat.…”