Intra-abdominal hemorrhage following ultrasound-guided transvaginal oocyte retrieval: Retrospective analysis of 25 cases

Background

Intra-abdominal hemorrhage (IAH) is a rare but potentially life-threatening complication of ultrasound-guided transvanginal oocyte pick up (OPU). Despite the widespread use of OPU in assisted reproductive technology, minor hemorrhages may remain undetected without vigilant monitoring, potentially escalating to severe bleeding. This study aims to elucidate the clinical characteristics, risk factors, and management outcomes of IAH following OPU.

Methods

A retrospective analysis was conducted on 25 hospitalized patients who developed IAH within 7 days post-OPU at a university-affiliated hospital between 2010 and 2021. Data on demographics, clinical presentations, laboratory findings, treatment modalities, and reproductive outcomes were systematically reviewed.

Results

The incidence of IAH was 0.05% (95% CI, 0.03%–0.07%). Symptoms typically manifested within 12 hours post-OPU, with abdominal pain and distension being most common. Hemoglobin (Hb) and hematocrit (Hct) reductions averaged 26.50±13.32 mg/dL and 7.70±3.66%, respectively. Seventeen patients were managed conservatively, while 8 required surgical intervention. Notably, 52% of patients achieved live births, with no adverse pregnancy outcomes linked to IAH.

Conclusion

IAH is a rare but life-threatening OPU complication. Extended postoperative monitoring is critical for early diagnosis, with conservative management as the first-line approach.