Amount Of Peritoneal Fluid Research Articles

Predictive performance of peritoneal fluid in the pouch of Douglas measured five days after oocyte pick-up in predicting severe late-onset OHSS: A secondary analysis of a randomized trial

ObjectivesTo investigate if the amount of peritoneal fluid (PF) in the Pouch of Douglas at oocyte pick-up (OPU) or OPU + 5 days predict severe late-onset ovarian hyperstimulation syndrome (OHSS) in women undergoing ovarian stimulation for assisted reproductive technology (ART). Study designA secondary analysis of a dual-centre RCT on 1050 women referred for their first ART treatment in two public fertility clinics in Denmark and randomized 1:1 to GnRH-antagonist or GnRH-agonist protocol. All women from the two arms who were examined on day of OPU and OPU + 5 days were included in this study (n = 940). The ability of PF in the pouch of Douglas to predict severe late-onset OHSS was assessed by multivariate logistic regression analyses and receiver operator characteristics (ROC) curve analyses and compared with other known predictors of OHSS. The final models were cross-validated by the leave-one-out method to assess the models’ generalizability. ResultsA total of 28 (3%) women developed severe late-onset OHSS. PF in the pouch of Douglas measured on OPU + 5 days predicted severe late-onset OHSS. The optimal cut-off value was 17.5 mm at OPU + 5 days with a 61% sensitivity and 71% specificity (Area under the curve = 0.70 95% CI 0.61–0.80). PF on the day of OPU was not predictive of late on-set OHSS as the adjusted multivariate logistic regression analyses showed insignificant results. ConclusionAlthough PF in the pouch of Douglas could predict late-onset severe OHSS, the low sensitivity underlines that it is not useful as a sole marker to decide whether to perform blastocyst transfer or to use a freeze-all strategy.

Prognostic Factors of Non-Traumatic Small Bowel Perforation Peritonitis: A Multicenter Study in North Benin

Objective: Identify the factors affecting the non-traumatic intestinal perforations peritonitis outcome. Methods: This was a retrospective study over a period of 30 months (1st January 2014 – 30th June 2016), which took place in four hospitals in northern Benin, including three district hospitals and one teaching hospital. The study population consisted of patients operated for generalized acute peritonitis. The inclusion criteria were: peroperative confirmation of the non-traumatic ileal perforation and the existence of a complete medical record in relation to the variables studied. Results: We collected 121 cases of non-traumatic ileal perforation peritonitis with a total of 447 cases of generalized acute peritonitis; the non traumatic ileal perforation peritonitis frequency was 27.1%. Ninety-nine files met the inclusion criteria. The mean age was 17 ± 12 years with extremes of 2 and 60 years. The sex ratio was 2.4. The predictive factors were: age (p 0.00), consultation time (p 0.03), surgical time (p 0.02), amount of peritoneal fluid (p 0.001), perforation number (p 0.0009), surgical technique (p 0.0003) and postoperative complications such as digestive fistula (p 0.001) and postoperative peritonitis (p 0.04). Conclusions: At the end of our study, the factors of bad prognosis identified were the age, the time of consultation, the time of surgery, the quantity of peritoneal fluid. Some postoperative complications may cause death.

Evaluation of transabdominal ultrasound as a tool for predicting the success of abdominocentesis in horses

The aim of this study was to evaluate the transabdominal ultrasonography as a tool for predicting the success of abdominocentesis in horses. Patients were included in the study if a...

Pre-hCG variables associated with occurrence of ascites in IVF/ICSI patients at moderate risk of developing OHSS: A pilot investigation

Objective: To identify predictors of ascites collected prior to the hCG administration in patients undergoing IVF/ICSI treatment at moderate risk of developing moderate/severe ovarian hyperstimulation syndrome (OHSS), and, based on these predictors, develop a nomogram for estimation of the probability of presence of ascites. Methods and Materials: Data were derived from 53 patients with 20 - 30 follicles ≥10 mmat end of stimulation. All patients received a single dose of hCG (250 mg) to trigger final follicular maturation when ≥2 follicles of ≥18 mmwere observed. Transvaginal ultrasound to measure ascites (total amount of peritoneal fluid ≥9 cm2inlithotomy position) was performed 2, 5 and 8 days after the hCG administration. Associations between clinical, sonographic and endocrinological variables recorded prior to the hCG administration and presence of ascites were analyzed by univariable and multivariable logistic regression. Results: Thirty-four patients (64%) had ultrasonic evidence of ascites. The multivariable analysis identified the total number of follicles [OR 1.29 (95% CI: 1.02 - 1.69, P = 0.043)], the ovarian volume [OR 1.05 (95% CI: 1.00 - 1.11, P = 0.047)] and BMI [OR 0.76 (95% CI: 0.56 - 0.99, P = 0.053)] as predictors of ascites (AUC = 0.825). A nomogram (PROFET) was designed with these three variables for individual prediction of the probability of development of ascites. Conclusions: This pilot investigation indicates that the risk of peritoneal fluid accumulation in IVF/ICSI patients at moderate risk of developing moderate/severe OHSS is influenced by the number of follicles and the ovarian volume on the day of hCG administration as well as the BMI.

Factors influencing mortality in perforated duodenal ulcer following emergency surgical repair

Duodenal perforation is a common abdominal catastrophe with excellent outcome if prompt resuscitation and surgical repair of perforation are done. The aim of this study was to identify factors associated with death after surgery in patients with duodenal perforation. One hundred and forty-five patients who underwent Graham's patch repair for perforated duodenal ulcer between 14 April 2002 and 31 December 2004 were studied. The mean age was 45.99 years and 61 patients (42.07 %) were referrals. There were 124 (85.52 %) males and 21 (14.48 %) females. There were 10 deaths (6.9 %). The mean time delay was 2.46 days. It was 2.37 days in survivors, 3.7 days in non-survivors. The time delay was 3.25 days for females and 3.13 days for patients referred from another hospital. The mortality was significantly associated with time delay between perforation and operation (p<0.01), presence of co-morbid conditions (P<0.04), respiratory rate (p<0.02), raised blood urea (p<0.01) and serum creatinine (p<0.001), size of perforation (p<0.005), amount of peritoneal fluid (p=0.003) and requirement of postoperative intensive care unit support (p=0.003). Time delay between perforation and operation, preoperative blood urea and serum creatinine, size of perforation and amount of peritoneal fluid, presence of co-morbid conditions and need for post operative ICU support are the important predictors of outcome after emergency surgery for duodenal perforation.

The role of enalapril in the prevention of ovarian hyperstimulation syndrome: a rabbit model.

The purpose of our study was to investigate the role of enalapril in the prevention of ovarian hyperstimulation syndrome. Twenty New Zealand female rabbits were included in the study. A total of 75 IU FSH + 75 IU LH was given daily by i.m. route for the first 7 days and additionally 2500 IU HCG was given on the last day of ovarian stimulation. Between days 0 and 9, oral enalapril tablets (2 mg/kg) were given twice daily to 10 rabbits (group 1). The remaining 10 rabbits did not receive enalapril (group 2). Laparatomy was performed on all rabbits at day 9. The amount of peritoneal fluid and the weight of the ovaries were recorded during laparotomy. Serum renin, interleukin-6 (IL-6), oestradiol, progesterone, prolactin and aldosterone concentrations were assayed at day 0 and again at day 9 for all rabbits. Serum renin and IL-6 concentrations at day 9 increased significantly compared with basal values in both groups (P < 0.05). Renin was correlated with IL-6 at day 9 in both groups (P < 0.05). The amount of peritoneal fluid and the increase in body weight observed at day 9 were not significantly different between groups 1 and 2. Administration of enalapril did not prevent the formation of ascites in group 1 despite the low serum aldosterone concentrations. In group 1 the weight of ovaries was significantly higher than the control group (P < 0.05). Renin-angiotensin system and IL-6 may play a role in the aetiopathogenesis of ovarian hyperstimulation syndrome. Administration of enalapril did not seem to have any beneficial effect in reducing the severity of ovarian hyperstimulation syndrome.

Prognostic Factors Of Typhoid Perforation in Lagos

Perforation of the ileum remains one of the commonest and the most dramatic complication of Typhoid fever in developing countries where the infection is still prevalent. A prospective study of patients with typhoid perforation seen at the Lagos University Teaching Hospital was carried out over a 6-year period. There were 78 consecutive patients, the majority (80.7%) of whom were within the age range of 11 and 30 years (mean 20.9 +SD 11.2 years) and were mostly (65.4%) students. All patients were managed using the standard procedure of prompt surgical intervention after adequate resuscitation. The mean of the period of resuscitation was 20.10 + SD 9.3 hours. The case fatality rate of 12.8% and the mean period of hospitalisation for survivors was 21.1 + 11.7 days. The study showed that high serum urea levels, acidosis, presence of jaundice and very large amount of peritoneal fluid (above 1 litre) were associated with poor prognosis. However, there was no statistically significant difference (P > 0.05) between survivors and non-survivors as regards the age, sex, temperature at presentation, pulse rate, serum Na+, serum K+ and both the site and number of ileal perforations. It is concluded that patients with typhoid perforation need to present early because in spite of appropriate intervention, most of those who are jaundiced, uraemic or acidotic carry poor prognosis and should be ideally managed in an intensive care setting. Nigerian Quarterly Journal of Hospital Medicine Vol. 9, No. 1 (1999) pp. 78-83

Posttraumatic peritoneal fluid: Is it a reliable indicator of intraabdominal injury in children?

Clinical data and computed tomographic (CT) scans for 1,486 children evaluated after blunt abdominal trauma were reviewed to determine whether peritoneal fluid is a reliable indicator of the presence and severity of associated intraabdominal injury and the need for laparotomy. The CT scans were assessed for presence, location, and severity of intraabdominal injury, and amount of peritoneal fluid. Type of management (surgical or nonsurgical), indications for surgical management, overall hospital course, and clinical outcome were recorded at the time of discharge. Of the 326 children with abdominal injuries detected by CT, 121 (37%) had no associated peritoneal fluid collections. Eighteen (15%) of these children had injury to more than one abdominal organ. Splenic injuries by CT criteria were more severe in children with associated peritoneal fluid than in those with no associated fluid ( P < .003). There were no significant differences in CT grading of liver and renal injuries among those with and without associated peritoneal fluid ( P > .67). Two hundred fifty-nine (17%) of the 1,486 children had peritoneal fluid demonstrated by CT. Eighty percent of these children had concomitant intraabdominal injury. Associated injuries included solid organ injuries (in 68% of patients) hollow viscus or mesenteric injury (11%), isolated pelvic fracture (4%), and hypoperfusion syndrome (5%). Thirty-one patients (12%) had injury to more than one abdominal organ. Only 27 (11%) patients had small “unexplained” collections of peritoneal fluid in which no associated injury was detected through CT or clinical follow-up. The authors conclude that (1) solid organ injury is frequently present in the absence of peritoneal fluid, and (2) the identification of peritoneal fluid after blunt trauma should lead one to suspect that a specific intraabdominal injury is the causes of the fluid.

RELATION OF PLASMA PROTEINS TO ASCITES AND EDEMA IN CIRRHOSIS OF THE LIVER

In cirrhosis of the liver the accumulation of fluid in the peritoneal cavity is generally associated with a high degree of portal obstruction. This has been demonstrated repeatedly, but in a most convincing manner by McIndoe.1However, clinical observations suggest that other factors play important parts. The spontaneous variation of the amount of peritoneal fluid, the diminution of the ascites following the administration of diuretics and the changes subsequent to an alcoholic bout or an attack of dysentery are difficult to explain on the basis of portal obstruction alone. Dependent edema of varying degree is frequently observed in patients with cirrhosis of the liver and portal obstruction. The edema of these patients has been explained on a basis of increased intraabdominal pressure, causing obstruction of the venous return from the legs, or as a manifestation of cardiac failure. There are many patients concerning whom these explanations are inadequate. Edema