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Rudranshi Arora

PREGNANCY AND PCOS

Updated: Oct 25, 2021



Polycystic Ovarian Syndrome (PCOS) is a condition that affects to 6 – 15 % of the women during the childbearing age. PCOS, also known as Stein-Leventhal syndrome, is a hormonal imbalance that affects women. It’s characterized by the production of too many androgens, or “male” hormones.PCOS can cause women to develop excessive hair and acne. It can also cause cysts on the ovaries and interrupt normal menstrual cycles. If you are diagnosed with this syndrome then there is very less chance to become pregnant. And if anyhow you would be able to become pregnant then there will be consequences during the time of pregnancy, delivery and labor. Women with PCOS lead to three times miscarriage than the women who are not diagnosed with PCOS. They most likely develop preeclampsia, gestational, diabetes and have a larger baby and a premature baby. This could lead to difficulty during delivery or cesarean delivery.


PCOS SYMPTOMS


PCOS often gets missed in women because of the difficulty of making a diagnosis. The symptoms can vary and occur in many different types of women.

Obesity or weight gain, for example, can be a frequent occurrence with PCOS. But it’s not a given. Many women with PCOS have lean body shapes.

Unfortunately, up to 50 percent of women who have PCOS never actually get diagnosed. Because of this, PCOS is sometimes called the silent killer.

Some of the more common symptoms of PCOS include:

  • “String of pearl” cysts on the ovaries

  • insulin resistance

  • high testosterone causing excessive hair growth, male pattern baldness, and acne

  • suppressed ovulation

  • excessive weight gain

  • weight gain on the waistline

  • dark, thick patches of skin on the neck, arms, breasts, or thighs

  • skin tags in the armpits or neck area

  • pelvic pain

  • anxiety or depression

  • sleep apnea



· RISK FOR MOM TO BE WITH PCOS


Having PCOS would lead to have difficulty in being pregnant. This might lead to the hormonal imbalances. In a study it is found that 60% of the women with PCOS are obese. And almost 14% women needs reproductive technology to get pregnant. Women who have PCOS are suffers from severe medical complications throughout her life including:


*High Blood Pressure

* Type 2 Diabetes

* Heart Disease

*Stroke

*Sleep apnea

*Insulin resistance

*High Cholesterol

*Increased risk of endometrial cancer


Pregnant women who suffer from PCOS brings an increased complication. This includes preeclampsia, a dangerous condition for both mother and baby-to-be. The recommended treatment to resolve symptoms is delivery of the baby and placenta. If you develop preeclampsia during your pregnancy, you will have to be monitored extremely closely. Other concerns include pregnancy-induced hypertension (high blood pressure) and gestational diabetes.Having gestational diabetes could lead to you having a larger-than-average baby. This could lead to problems during delivery. For example, larger babies are more at risk for shoulder dystocia (when the baby’s shoulder gets stuck during labor).


Most PCOS symptoms during pregnancy can be treated with careful monitoring. If you develop gestational diabetes, insulin may be required to keep your blood sugar levels stable.


RISKS FOR BABY


Having PCOS during pregnancy can cause severe complications. It requires serious monitoring for mother and the baby. The risks with the baby include:

· Premature birth

· Large for gestational age

· Miscarriage

· Lower Apgar score


If your baby is a girl, some studies have shown that there is up to a 50 percent chance that she will also have PCOS.Women with PCOS are also more likely to deliver by caesarean because they tend to have larger-sized babies. Other complications may also come up during labor and delivery.

TREATMENT FOR PCOS


There’s currently no cure for PCOS. But it’s possible to manage symptoms.Options to help manage symptoms include:

  • Birth control pills

  • Weight loss

  • Spironolactone

  • Other androgen blockers

Along with other fertility drugs, metformin, which helps to control blood sugar, is commonly prescribed to help induce ovulation.


How does normal ovulation work?


In a normal menstrual ovulation, a number of eggs mature in follicles in your ovaries. The ripest egg is released into one of your fallopian tubes, where it meets the sperm if there is any. If you have PCOS although the polycystic ovaries contain follicles with eggs in them, the follicles do not develop and mature properly - so there is no ovulation or release of eggs. This is called an ovulation. Many women do not find out they have PCOS until they try to conceive, particularly if they were using contraception that uses hormones, which masks irregular or no periods, because it allows for a monthly bleed.


DIAGNOSIS


It often takes a while for women with PCOS to get a firm diagnosis, as the condition can mimic other problems. Sometimes women having trouble getting pregnant find they have PCOS.If you think you might have PCOS, it is important you see your doctor to find the cause of your symptoms. With early diagnosis, the symptoms of PCOS can be treated early. This reduces the risk of complications if you do decide to become pregnant.

- At your appointment, your doctor will:

- Talk to you and examine you

- Take a blood test to check for male hormones

- Arrange ultrasound scans to look for cysts in the ovaries


HORMONE DIFFERENCES


· PCOS causes a woman’s body to produce higher-than-normal levels of androgen. These are hormones that are usually thought of as male hormones, because men have much higher levels of androgen than women.

· Androgens are important in the development of male sex organs and other male traits.

· In women, androgens are usually converted into the hormone estrogen.


Ovulation Problems

High levels of androgens interfere with the development of your eggs and the regular release of your eggs. This process is called ovulation. If a healthy egg isn’t released, it can’t be fertilized by sperm, meaning you can’t get pregnant. can cause you to miss your menstrual period or have irregular periods. This can be one of the first signs that you may have a problem such as PCOS.

Regulating Your Period

Fortunately, there are some treatments that can help women with PCOS have healthy pregnancies. Your doctor may prescribe birth control pills that contain man-made versions of the hormones estrogen and progestin. These pills can help regulate your menstrual cycle by reducing androgen production. If you cannot tolerate a combination birth control pill, your doctor might recommend a progestin-only pill.You take this pill for about 2 weeks a month, for about 1-2 months. It’s also designed to help regulate your period.


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