- Title:
- Minimizing the Risk of Infection and Bleeding at Trans-Vaginal Ultrasound-Guided Ovum Pick-up: Results of a Prospective Web-Based World-Wide Survey
- Journal:
- J Obstet Gynaecol India. 2015 Dec; 65(6): 389–395
- Author(s):
- Bhandari H1, Agrawal R1, Weissman A2, Shoham G3, Leong M4, Shoham Z5
- Author(s) affiliation:
- 1Centre for Reproductive Medicine, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, Warwickshire CV2 2DX UK ; The University of Warwick, Coventry, Warwickshire UK.
2 IVF Unit, Department of Obstetrics and Gynaecology, Edith Wolfson Medical Center, Holon, Israel ; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
3Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
4 IVF Center, The Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong, China.
5The Reproductive Medicine Unit, Kaplan Medicine Center, Rehovot, Israel ; Hadassah Medical School, Affiliated to the Hebrew University, Jerusalem, Israel.
- Short description:
- Trans-vaginal ultrasound-guided ovum pick-up (TV-OPU) under ultrasound guidance is an essential procedure of assisted reproductive technique (ART). TV-OPU is a relatively straight forward and a safe procedure, compared with the historical laparoscopic and complex trans-abdominal approaches. All surgical procedures are associated with complications and therefore, a sharp needle introduced through the vaginal walls into the ovaries at TV-OPU carries the risks of bleeding, infection, and injury to the surrounding abdominal viscera. Though uncommon, severe bleeding and infection are the most commonly quoted complications with TV-OPU.
- Link to the journal
Abstract taken from PubMed
- Background:
- The objective of this study was to identify clinical practices worldwide, which would help in recognizing women at risk of excessive bleeding or of developing pelvic infection following trans-vaginal ovum pick-up (TV-OPU), measures taken to minimize risks and their management.
- Methods:
- A prospective, web-based questionnaire with distinct questions related to the practice of TV-OPU.
- Results:
- A total of 155 units from 55 countries performing 97,200 IVF cycles annually responded to this web-based survey. A majority (65 %) responded that they would routinely carry out full blood count, while 35 % performed coagulation profile. Less than a third agreed screening women for vaginal infections. About a third used both sterile water and antiseptic to minimize ascending infection, and 52 % used antibiotics for prophylaxis. Doppler ultrasound was routinely used by 20 % of clinicians. 73 % of the clinicians preferred conservative management as their first line management for patients diagnosed with intra-abdominal bleeding.
- Conclusions:
- The study has identified a wide variation in the practices of minimizing infection and bleeding complications. The dearth of good quality evidence may be responsible for the lack of published guidelines, and therefore a lack of consensus on the optimum practice for minimizing the risk of infection and bleeding during TV-OPU.
- Link to the paper on PubMed
