Pregnancy outcome in severe OHSS patients following ascitic/plerural fluid drainage

Background: Various inflammatory cytokines have been implicated in the pathophysiology of severe ovarian hyperstimulation syndrome, as well as, various pregnancy complications, including preterm labor, pregnancy induced hypertension/preeclampsia and intra-uterine growth restriction. We aim to determine whether severe OHSS, complicated by third space fluid accumulation necessitating drainage, is associated with increased risk of late obstetrics complications. Methods. We assessed the obstetrics and neonatal outcome measures of 16 patients admitted to our gynecology ward during a 6-year period, with severe OHSS complicated by third space fluid accumulation necessitating drainage. Results: Patients delivered at 37.3 ± 5.9weeks, with a mean birth weight of 3062 ± 757 gr. There was no single case of gestational diabetes, hypertensive diseases of pregnancy, nor placental abruption. Two (12.5%) patients had preterm delivery: one at 23 weeks' gestation and one at 28 weeks' gestation following preterm premature rupture of membrane. Another patient experienced an unexplained antepartum fetal death at 27 weeks' gestation. Conclusions: Severe OHSS, complicated by third space fluid sequestration necessitating drainage, is not associated with adverse late pregnancy outcome, except probably for preterm labor. Following resolution of the OHSS, pregnancies should be regarded as any pregnancy resulting from IVF treatment, with special attention to prevent preterm labor.