title: Outpatient Management of Severe Ovarian Hyperstimulation Syndrome (OHSS) with Placement of Pigtail Catheter.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of outpatient management of severe ovarian hyperstimulation syndrome (OHSS) requiring placement of a pigtail catheter.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  The placement of a pigtail catheter resulted in safe and effective outpatient management for the majority of patients with severe OHSS.
authors.affiliation: 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.
authors.forename: M
authors.initials: M
authors.lastname: Abuzeid
authors.affiliation: 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.
authors.forename: H
authors.initials: H
authors.lastname: Warda
authors.affiliation: Michigan State University, Department of Obstetrics and Gynecology.
authors.forename: S
authors.initials: S
authors.lastname: Joseph
authors.affiliation: Michigan State University, Department of Obstetrics and Gynecology.
authors.forename: M G
authors.initials: MG
authors.lastname: Corrado
authors.affiliation: Michigan State University, Department of Obstetrics and Gynecology.
authors.forename: Y
authors.initials: Y
authors.lastname: Abuzeid
authors.affiliation: Hurley Medical Center, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Flint USA 48503 ; Michigan State University, Department of Obstetrics and Gynecology ; Reproductive Biology, College of Human Medicine, Flint Campus, Flint, USA 48503.
authors.forename: M
authors.initials: M
authors.lastname: Ashraf
authors.affiliation: University of South Alabama, Professor and head, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mobile, USA 36604.
authors.forename: B
authors.initials: B
authors.lastname: Rizk
keywords: Complication; IVF; OHSS; Pigtail catheter; management; outcome; outpatient