Complications of transvaginal ultrasound-directed follicle aspiration: A review of 2670 consecutive procedures

Abstract

Complications following transvaginal ultrasound-directed follicle aspiration are rare, making it difficult to assess their true incidence. During a 4-year prospective study the complications arising from a series of 2670 consecutive procedures were monitored. Vaginal hemorrhage occurred in 229 (8.6%) of the cases, with a significant loss (>100 ml) in 22 (0.8%). Postoperative pelvic infection occurred in 18 (0.6%) of the cases. Hemorrhage from the ovary with hemoperitoneum formation was seen on two occasions and necessitated emergency laparotomy in one instance. A single case of pelvic haematoma formation from a punctured iliac vessel was also recorded; this settled without intervention. Of the 18 cases with infection, 9 were severe with pelvic abscess formation; microbiological examination of the pus from these cases suggests that the most common route of infection in such cases is probably by direct inoculation of vaginal organisms into the peritoneal cavity by the collecting needle. The low incidence of pelvic infection questions the value of using prophylactic antibiotics. No increased risk of infection was demonstrated in cases with preexisting peritoneal damage.