Effect of pigtail catheter application on obstetric outcomes in in vitro fertilization/intracytoplasmic sperm injection pregnancies following hyperstimulation syndrome

Abstract

Objective:To evaluate the effects of percutaneous pigtail catheter drainage on the outcomes of intracytoplasmic sperm injection (ICSI) pregnancies following moderate or severe ovarian hyperstimulation syndrome (OHSS).Materials and Methods:This retrospective study included 189 patients hospitalized for OHSS following ICSI treatment in a tertiary in vitro fertilization unit between 2006 and 2014. Pigtail catheters were applied in 63 patients; the other 126 patients did not need that treatment. The obstetric reports of 173 patients could be accessed and were examined to investigate the pregnancy outcomes of those with and without catheters.Results:No complications such as infection or vascular or intra-abdominal organ trauma were observed related to the pigtail application. There were no differences in abortus, preterm labor, gestational diabetes mellitus, and preeclampsia ratio between the pigtail and control groups (p>0.05). The rate of readmission to hospital for OHSS was lower in the pigtail group than in the control group although not statistically significant (p=0.08).Conclusion:Pigtail application is a safe and effective method for draining ascites in patients with OHSS after ICSI treatment. The use of pigtail catheters had no adverse effects on the perinatal outcomes of patients hospitalized with OHSS who became pregnant after ICSI treatment. In addition, the percutaneous drainage of ascites via a pigtail catheter helped prevent the readmission of patients with moderate or severe OHSS.

Pregnancy outcome in late-onset severe OHSS patients following different ascetic fluid drainage and comparison with the non-OHSS IVF patients

“…In case of severe ascites associated with OHSS, ascites drainage is necessary, because severe ascites intra-abdominal pressure is increasing, uterine perfusion decreases, and for some OHSS patients with respiratory compromise due to massive ascites, repeated abdominal paracentesis has been proposed, and it can also improve the respiratory symptoms in patients with pleural effusion. Repeated abdominal paracentesis has the danger of infection, vascular, ovarian and gut injury, and bring more pain and inconvenience to the patient, and abdominal pressure uctuate drastically, Following abdominal paracentesis, in our data, treatment required drainage of uid mostly one to three times, in some cases even six to seven times, Compared with standard paracentesis, central venous catheter is a way of continuous drainage of ascetic uid, its use improves patient care and reduces suffering, studies have reported the use of central venous drainage in the ascites effusion [15][16][17], but our study is the rst in compare the treatment effect of standard paracentesis and central venous catheter. The ndings reported herein indicate that central venous catheter is a convenient way of ascites drainage, avoiding repeated paracentesis, the patients symptoms relieve as soon as the central venous catheter was placed, as long as the catheter was in place, there was no recurrence of symptoms, the abdominal pressure was stable, according to our data the preterm rate of the central venous group was much low than the paracentesis group, when OHSS does occur, and paracentesis is necessary for severe ascites, when repeated attempts seem likely, central venous catheter is a better alternative to repeated abdominal paracentesis in the management of severe ascites of severe OHSS.…”