Day care management of severe ovarian hyperstimulation syndrome avoids hospitalization and morbidity

Severe ovarian hyperstimulation syndrome (OHSS) is a dreadedcomplication of ovulation mductlon for assisted reproductiontreatment. In the past, conservative management has been recommendedand this leads to prolonged hospitalization. A total of 18 patientswho developed severe OHSS were managed according to two protocols.The first group (n=8) was managed conservatively with hospitalization,i.v. hydration and supportive therapy. The average durationof hospitalization was 11 days and the patients were uncomfortablethroughout. A second group (n=10) was managed on an out-patientbasis with early, ultrasound-guided trans-abdominal paracentesis.While the patient was hydrated intravenously, 1–3 I offluid were removed over 2–3 h. The duration of hospitalizationwas between 6 and 7 h and no in-patient stay was required. Promptrelief of symptoms was reported and none of the patients requiredre-tapping. Pregnancy was achieved in 68% of all patients. Daycare management with easy abdominal paracentesis was found tobe simple, safe and effective; patients found it more acceptableas it avoided in-patient hospitalization.