Management of associated risks of pregnancy in polycystic ovary syndrome

Document Type

Book Chapter

Edition

1

ISBN

9780323879323

Editor

Rehana Rehman and Aisha Sheikh

Publication (Name of Journal)

Polycystic Ovary Syndrome: Basic Science to Clinical Advances Across the Lifespan

Department

Obstetrics and Gynaecology

DOI

https://doi.org/10.1016/B978-0-323-87932-3.00029-3

Publisher

Elsevier

City

United States

Abstract

Polycystic ovary syndrome (PCOS) is among the most common endocrinologic disorders affecting females in the reproductive age group. It is diagnosed by its hallmark features of hyperandrogenism (HA) and ovulatory dysfunction leading to menstrual irregularities and typical ultrasonographic features of polycystic ovaries. The basic metabolic pathology of PCOS is thought to be closely linked with HA and insulin resistance (IR), which is linked with adverse pregnancy outcomes, such as miscarriages, fetal growth restriction, hypertensive disorders, diabetes during pregnancy, and preterm birth, by altering normal placental implantation, especially in obese females. Patients with PCOS should have preconception counseling about the metabolic, psychological, and reproductive repercussions. The management should start in the preconception period with advice on healthy lifestyle modifications, modest prepregnancy weight loss in overweight and obese females through moderate physical activity, and consumption of a healthy diet to optimize health before planning pregnancy. With healthy lifestyle interventions, excessive weight gain during pregnancy can be prevented and can improve the pregnancy outcomes in these high-risk cases. Metformin has been widely used for the management of diabetes during pregnancy; however, because the long-term effects on the offspring are unknown, its use in PCOS patients without gestational diabetes mellitus is not recommended. Similarly, the role of Myo-inositol is still not clear in PCOS.

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