DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20173625

Polycystic ovarian syndrome and pregnancy outcome

Chaitra Shivananjaiah, Abinaya Kannan, Mridula Devi, . Jayanthi, Satish D., Renuka Ramaiah

Abstract


Background: Polycystic ovarian syndrome (PCOS) in the present generation is a very common reproductive disorder and the prevalence is on the rise. It is associated with typical features such as insulin resistance, hyperandrogenemia and obesity which has deep implications on the pregnancy outcomes as well as a long-term health of the woman.

Methods: Prospective comparative study performed over 200 pregnant women in the ESIC medical college, Bangalore. 100 women diagnosed with PCOS were compared with that of 100 normal women. The method of conception in pcos was recorded. maternal outcome in the form of abortion, gestational diabetes mellitus, hypertensive disorder in pregnancy, mode of delivery, intrapartum and postpartum complication. Fetal outcome in the form preterm delivery, small-for-gestational-age (SGA) infants, large-for-gestational-age infants, apgar at 5 minute and admission to NICU.

Results: Of the 100 women who were diagnosed with PCOS, 62 had spontaneous conception, 32 conceived with ovulation induction, 4 with artificial insemination and 2 needed IVF for conception. 18 women had spontaneous abortion, 58 were diagnosed with Gestational diabetes mellitus (GDM) predominantly between 24 – 28 weeks’ period of gestation, 16 women had hypertension complicating pregnancy. Fetal outcome in the form of preterm birth was noted in 14 patients, large for gestation was noted in 11 newborns, the rate of NICU admission was significantly higher in the PCOS women’s infants constituting 33%.

Conclusions: The assistance needed for conception was significantly higher in women with PCOS. The complications associated with pregnancy such as spontaneous abortions, gestational diabetes, hypertensive disorder in pregnancy, preterm births, need of NICU care for the infants are much higher in women with PCOS.  Adult health education and the preconception diagnosis and appropriate management of PCOS is an important primary mode of prevention of these associated complications.

 


Keywords


Gestational diabetes mellitus, Hyperandrogenemia, Insulin resistance, Obesity, Polycystic ovarian disease, Preterm

Full Text:

PDF

References


Franks S. Polycystic ovary syndrome. N Engl J Med. 2001;333:853-61.

Archer JS, Chang RJ. Hirsutism and acne in polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol. 2004;18:737-54.

Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol. 1935;29:181-91.

The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Human Reprod. 2004;19:41-7.

Laven JS, Imani B, Eijkemans MJ and Fauser BC. New approach to polycystic ovary syndrome and other forms of anovulatory infertility. Obstet Gynecol Surv. 2002;57:755-67.

Norman RJ, Noakes M, Wu R, Davies MJ, Moran L, Wang JX. Improving reproductive performance in overweight/obese women with effective weight management. Hum Reprod Update. 2004;10:267-80.

Legro RS, Castracane VD, Kauffman RP. Detecting insulin resistance in polycystic ovary syndrome: purposes and pitfalls. Obstet Gynecol Surv. 2004;59:141-54.

Wild RA. Long-term health consequences of PCOS. Hum Reprod Update. 2002;8:231-41.

Barker DJ. Fetal programming of coronary heart disease. Trends Endocrinol Metab. 2002;13:364-8.

Balen AH, Braat DD, West C, Patel A, Jacobs HS. Cumulative conception and live birth rates after the treatment of anovulatory infertility: safety and efficacy of ovulation induction in 200 patients. Hum Reprod. 1994;9:1563-70.

Eijkemans MJ, Imani B, Mulders AG, Habbema JD, Fauser BC. High singleton live birth rate following classical ovulation induction in normogonadotrophic anovulatory infertility (WHO 2). Hum Reprod. 2003;18:2357-62.

Haakoova L, Cibula D, Rezabek K, Hill L,Fanta M. Pregnancy Outcome in women with PCOS and controls matched by age and weight. Human Reprod. 2003;18(7):1438-41

Setji TL, Brown AJ, Feinglos MN. Gestational diabetes mellitus. Clin Diab. 2005;23(1):17-24.

Nivedhitha VS, Sankareswari R. Pregnancy outcome in women with polycystic ovary syndrome. Int J Reprod Contracept Obstet Gynecol. 2015;4:1169-75.

Holte J. Disturbances in insulin secretion and sensitivity in women with the polycystic ovary syndrome. Ballieres Clin Endocrinol Metab. 1996;10:221-47.

Lo JC, Feigenbaum SL, Escobar GJ, Yang J, Crites YM, Ferrara A. Increased prevalence of gestational diabetes mellitus among women with diagnosed polycystic ovary syndrome: a population based study. Diab Care. 2006;29(8):1915-21.

Boomsma CM, Eijkemans MJC, Gughes EG, Visser GHA, Fauser BCJM, Maclon NS. A meta analysis of pregnancy outcomes in women with polycystic ovarian Syndrome. Hum Reprod. 2006;12(6):673-83.

Bjercke S, Dale PO, Tanbo T, Storeng R, Ertzeid G, Abyholm T. Impact of insulin resistance on pregnancy complications and outcome in women with polycystic ovary syndrome. Gynecol Obstet Invest. 2002;54:94-8.