emDocs - October 23, 2016 - Author: Cassella C - Edited by: Jamie Santistevan J and Koyfman A
"Pearls and Pitfalls for ART Patients
- Complications bringing patients to the ED post ART include: pelvic infection, ovarian torsion, OHSS, ectopic/heterotopic pregnancy, and miscarriage
- Early consultation with gynecology may be helpful in all post-procedure or pregnant ART patients
- If suspecting OHSS defer pelvic examination until consultation with gynecology
- Severe OHSS is a life threatening syndrome requiring aggressive IVF resuscitation
- Beware of electrolyte abnormalities and coagulopathy in OHSS
- Presence of IUP alone does not exclude ectopic pregnancy in ART
- Obtain adnexal ultrasound to evaluate for ectopic in ART patients
- If IUP is visualized, free fluid in the abdomen, abnormal adnexa, or hemodynamic instability should prompt surgical exploration for heterotopic"