ABSTRACT
OBJECTIVE: To evaluate the efficacy and safety of outpatient management of severe ovarian hyperstimulation syndromeâ(OHSS) requiring placement of a pigtail catheter. METHODS: retrospective analysis of thirty-three consecutive patients who underwent in-vitro fertilizationâ(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 patientsâ(9.1%) OHSS started early, requiring placement of a pigtail catheter 4.3 + 0.6 days after retrieval. In 30 patientsâ(90.9%) OHSS started lateâ(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 transferâ(two had total freeze), 84% conceived. Twenty-nine patientsâ(88%) were managed on outpatient basis without any complications. Four patients required hospital admission for 1-7 daysâ(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. CONCLUSION: The placement of a pigtail catheter resulted in safe and effective outpatient management for the majority of patients with severe OHSS.