Unilateral vulvar edema associated with paracentesis in patients with severe ovarian hyperstimulation syndrome: A report of nine cases

Dov Luxman*, Jacob R. Cohen, David Gordon, Igal Wolman, Yoram Wolf, Menachem P. David

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

BACKGROUND: Severe ovarian hyperstimulation syndrome is a life- threatening complication of ovulation induction. The clinical picture includes ovarian enlargement, accumulation of ascites and pleural effusion, increased coagulability and electrolyte disorders. Accumulation of ascites increases the intraabdominal pressure so that breathing difficulties ensue. Paracentesis is the only treatment that can immediately prevent respiratory deterioration. CASES: Nine women with severe ovarian hyperstimulation syndrome were treat ed by paracentesis for the one drainage of massive ascites. Unilateral vulvar edema developed in all cases in which with the lower abdomen was the puncturing site. This phenomenon was not observed when paracentesis was carried out through the upper abdomen. The edema resolved spontaneously over the subsequent 10 days. CONCLUSION: Apparently the puncturing needle created a fistulous tract through which the ascitic fluid was forced, by the increased intraabdominal pressure, into the subcutaneous tissues, presenting as unilateral vulvar edema. This can be prevented by using one of the abdominal hypochondriac regions as the puncturing site. This phenomenon is self-limited and causes only mild discomfort without late sequelae.

Original languageEnglish
Pages (from-to)771-774
Number of pages4
JournalThe Journal of reproductive medicine
Volume41
Issue number10
StatePublished - Oct 1996

Keywords

  • edema
  • ovarian hyperstimulation syndrome
  • paracentesis
  • vulvar diseases

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