Punkce ascitické tekutiny v léčbě těžké formy ovariálního hyperstimulačního syndromu

Puncture of the Ascitic Fluid in the Treatment of Severe Ovarian Hyperstimulation Syndrome

Objective:
Evaluate the contribution and complications of ascitic fluid puncture in the treatment of severe ovarian hyperstimulation syndrome.Design: Retrospective analysis of 18 patients.Setting: Department of Gynaecology and Obstetrics, University Hospital, Palacky University, Olomouc.Methods: 18 patients with the diagnosis of severe ovarian hyperstimulation syndrome admitted to intensive care unit from January 1996 to June 2000 were analysed. As a part of the therapy of severe OHSS 11 punctures of ascitic fluid was performed. In 3 patients the reinfusion of the ascites into the blood circulation was performed.Results: The transabdominal paracentesis under the ultrasound control in 11 patients was performed. In 6 patients the puncture had to be repeated. The amount of removed ascitic fluid in single procedure was between 600 - 3750 ml. Total amount of fluid in different patients was between 1500-17300 ml. Sterility of ascites and high contents of proteins was proved. In 3 patients with the refractory ascites the reinfusion of the ascitic fluid to the circulation was performed. No serious complications of the punctures were observed, 4 patients had a slight rise of body temperature, which fell down without antibiotics therapy.Conclusion: Puncture of the ascitic fluid is a save and effective part of the therapy of severe OHSS. In the treatment of the refractory ascites the reinfusion of the ascitic fluid should be used.

Key words:
severe ovarian hyperstimulation syndrome, puncture of the ascites, reinfusion of the ascitic fluid