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PubMed1998

Transvaginal drainage of ascites as an alternative to abdominal paracentesis in patients with severe ovarian hyperstimulation syndrome, obesity, and generalized edema.

OBJECTIVE: To describe an alternative technique for transvaginal drainage of ascites in a case of severe ovarian hyperstimulation syndrome (OHSS), generalized edema, and obesity. DESIGN: Case report. SETTING: A university-based hospital IVF and Reproductive Medicine Unit. PATIENT(S): A patient hospitalized with severe OHSS after IVF-ET in whom drainage of large amounts of ascitic fluid was necessary. INTERVENTION(S): 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. MAIN OUTCOME MEASURE(S): Amount of drained ascitic fluid. RESULT(S): Ascitic fluid was drained efficiently, leading to improvement of the patient's condition. CONCLUSION(S): 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.

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