title: Transvaginal drainage of ascites as an alternative to abdominal paracentesis in patients with severe ovarian hyperstimulation syndrome, obesity, and generalized edema.
abstract: OBJECTIVE
  To describe an alternative technique for transvaginal drainage of ascites in a case of severe ovarian hyperstimulation syndrome (OHSS), generalized edema, and obesity.
  
  
  METHODS
  Case report.
  
  
  METHODS
  A university-based hospital IVF and Reproductive Medicine Unit.
  
  
  METHODS
  A patient hospitalized with severe OHSS after IVF-ET in whom drainage of large amounts of ascitic fluid was necessary.
  
  
  METHODS
  Ultrasonographic transvaginal insertion of a wire guide through a standard IVF needle into the Douglas pouch. Placement of a "peel-away" set on the wire, which was replaced with a "pigtail" indwelling catheter.
  
  
  METHODS
  Amount of drained ascitic fluid.
  
  
  RESULTS
  Ascitic fluid was drained efficiently, leading to improvement of the patient's condition.
  
  
  CONCLUSIONS
  Transvaginal ultrasonography-guided insertion of a pigtail catheter through the Douglas pouch is an efficacious procedure when the abdominal approach for decompression of ascites is difficult.
authors.affiliation: IVF and Infertility Unit, Assaf Harofeh Medical Center, Zerifin, Israel. RONEL@POST.TAU.AC.IL
authors.forename: A
authors.initials: A
authors.lastname: Raziel
authors.forename: S
authors.initials: S
authors.lastname: Friedler
authors.forename: M
authors.initials: M
authors.lastname: Schachter
authors.forename: D
authors.initials: D
authors.lastname: Strassburger
authors.forename: I
authors.initials: I
authors.lastname: Bukovsky
authors.forename: R
authors.initials: R
authors.lastname: Ron-El
mesh_terms: D000328:Adult; D001201:Ascites / Q000150:complications / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D004487:Edema / Q000150:complications / Q000601:surgery; D004624:Embryo Transfer / Q000009:adverse effects; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D009765:Obesity / Q000150:complications; D016471:Ovarian Hyperstimulation Syndrome / Q000150:complications / Q000503:physiopathology / Q000601:surgery*