Abuzeid M, Warda H, Joseph S, Corrado M G, Abuzeid Y, Ashraf M, Rizk B
Hurley Medical Center, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Flint USA 48503 ; Hurley Medical Center, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Flint USA 48503 ; Hurley Medical Center, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Flint USA 48503.
Hurley Medical Center, Department of Obstetrics and Gynecology, Flint, USA 48503 IVF Michigan, PC, Rochester Hills, USA 48307 ; Reproductive Biology, College of Human Medicine, Flint Campus, Flint, USA 48503.
Facts Views Vis Obgyn. 2014;6(1):31-7.
To evaluate the efficacy and safety of outpatient management of severe ovarian hyperstimulation syndrome (OHSS) requiring placement of a pigtail catheter.
retrospective analysis of thirty-three consecutive patients who underwent in-vitro fertilization (2003-2009) and developed severe/critical OHSS requiring placement of a pigtail catheter. Patients who were managed on outpatient basis were monitored by frequent office visits, daily phone calls, and received IV normal saline for hydration when required.
In 3 patients (9.1%) OHSS started early, requiring placement of a pigtail catheter 4.3 + 0.6 days after retrieval. In 30 patients (90.9%) OHSS started late (14 ± 4 days after retrieval). The mean amount of ascitic fluid drained immediately after placement of the catheter was 2085 ± 1018 cc. The pigtail catheter was removed after 7.8 ± 5.3 days. Of the 31 patients who had embryo transfer (two had total freeze), 84% conceived. Twenty-nine patients (88%) were managed on outpatient basis without any complications. Four patients required hospital admission for 1-7 days (3.0 ± 2.7). One patient with severe OHSS was admitted for work up for chest pain. Three patients with critical OHSS with severe pleural effusion requiring thoracentesis were admitted for supportive measures.
The placement of a pigtail catheter resulted in safe and effective outpatient management for the majority of patients with severe OHSS.
评估门诊处理需放置猪尾导管的重度卵巢过度刺激综合征（OHSS）的疗效和安全性。
回顾性分析2003年至2009年连续33例行体外受精且发生需放置猪尾导管的重度/极重度OHSS的患者。门诊处理的患者通过频繁门诊就诊、每日电话随访进行监测，并在需要时接受静脉输注生理盐水补液。
3例患者（9.1%）OHSS早期发病，取卵后4.3±0.6天需放置猪尾导管。30例患者（90.9%）OHSS晚期发病（取卵后14±4天）。放置导管后立即引出的腹水平均量为2085±1018毫升。猪尾导管在7.8±5.3天后拔除。在31例进行胚胎移植的患者中（2例全部冷冻），84%成功受孕。29例患者（88%）门诊处理无任何并发症。4例患者需住院1 - 7天（3.0±2.7）。1例重度OHSS患者因胸痛入院检查。3例极重度OHSS伴严重胸腔积液需胸腔穿刺的患者因支持治疗入院。
对于大多数重度OHSS患者，放置猪尾导管可实现安全有效的门诊处理。
