title: Predictors of Paracentesis in Women with Severe Ovarian Hyperstimulation Syndrome: A Retrospective Cohort Study.
abstract: BACKGROUND
  To identify predictors of paracentesis in women with severe ovarian hyperstimulation syndrome (OHSS).
  
  
  METHODS
  In a retrospective cohort study, we assessed patient characteristics and outcome measures of women with severe OHSS Golan grade II/III from 1996 to 2010 using univariate and multivariate analyses with the number of paracenteses as the main outcome.
  
  
  RESULTS
  Three hundred ninety four women with OHSS Golan grade II (n = 40) and grade III (n = 354) were included in the study. Paracentesis was performed in 108/394 (27%) of these women. One paracentesis was performed in 63 (16%), 2 paracenteses in 26 (6%), and ≥3 paracenteses 19 (5%) women, respectively. No thrombotic or cerebrovascular morbidity occurred. The mortality of the cohort was 0/394 (0%). In a univariate analysis, late onset OHSS (p = 0.02), pregnancy (p < 0.001), human chorionic gonadotropin use (p = 0.02), ovarian diameter (p = 0.006), and elevated serum levels of alanine aminotransferase (p < 0.001), hematocrit (p < 0.001), leucocytes (p < 0.001), thrombocytes (p < 0.001), and uric acid (p < 0.001) were associated with paracentesis. In a multivariate logistic regression analysis, only alanine aminotransferase (OR 1.006; 95% CI 1.001-1.01) and hematocrit (OR 1.16; 95% CI 1.05-1.27) were independently associated with paracentesis.
  
  
  CONCLUSIONS
  Alanine aminotransferase and hematocrit at initial presentation are independent predictors of paracentesis.
authors.affiliation: Clinical Department of Gynecologic Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria.
authors.forename: Kazem
authors.initials: K
authors.lastname: Nouri
authors.forename: Johannes
authors.initials: J
authors.lastname: Ott
authors.forename: Christian
authors.initials: C
authors.lastname: Lenart
authors.forename: Katharina
authors.initials: K
authors.lastname: Walch
authors.forename: Regina
authors.initials: R
authors.lastname: Promberger
authors.forename: Clemens B
authors.initials: CB
authors.lastname: Tempfer
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001201:Ascites / Q000209:etiology / Q000601:surgery*; D005260:Female; D006400:Hematocrit; D006801:Humans; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood / Q000209:etiology / Q000601:surgery*; D010062:Ovulation Induction / Q000009:adverse effects; D019152:Paracentesis; D011237:Predictive Value of Tests; D027724:Reproductive Techniques, Assisted / Q000009:adverse effects*; D012189:Retrospective Studies; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000601:surgery
chemical_list: D000410:Alanine Transaminase