CONTINUOUS ASCITIC RECIRCULATION IN SEVERE OVARIAN HYPERSTIMULATION SYNDROME

Massive ascites, hydrothorax, acute renal failure and thromboembolism are clinical manifestations of severe ovarian hyperstimulation syndrom e (OHSS) which may complicate the induction of ovulation with exogenou s gonadotrophins. We report a case of severe OHSS with ascites formati on in excess of five litres per day. Massive ascites and bilateral ple ural effusions resulted in respiratory failure. Continuous ascitic rec irculation (AR) was commenced after repeated paracentesis and IV fluid therapy failed to improve the patient's condition. The procedure was undertaken for a total of 15 days and rapidly resulted in marked impro vement of impaired respiratory function. Febrile episodes occurred on 3 occasions, but we did not observe coagulation disturbances or advers e haemodynamic effects. Continuous AR is a safe and effective treatmen t of complicated severe OHSS.