The predictive value of uterine blood flow in detecting the risk of adverse pregnancy outcome in patients with polycystic ovary syndrome

ObjectivesTo assess the value of uterine artery Doppler screening during pregnancy in predicting adverse pregnancy outcomes in women with polycystic ovary syndrome (PCOS).DesignA prospective case control study.SettingObstetrics and Gynecology and Medical Biochemistry departments, Zagazig University Hospital, Egypt.MethodForty pregnant women with ovulatory PCOS (PCOS group) and 40 age- and body mass index-matched healthy pregnant controls (control group) underwent serial Doppler velocimetry measurements of the uterine artery, measurements of free androgen index and fasting glucose/insulin ratio during first and late second trimesters.Main outcome measuresBlood flow impedance indices, free androgen index, fasting glucose/insulin ratio and pregnancy outcomes. Student’s t-test, χ2-test, and specificity and sensitivity tests were used for statistical analysis of the data.ResultsPatients with PCOS had a significantly higher level of testosterone, androstenedione, dehydroepiandrosterone sulfate, free androgen index, fasting glucose/fasting insulin level in the first and late second trimesters (P ⩽ 0.05).A significantly (P < 0.05) higher PI value was observed in the PCOS group than in the control group in the first and late second trimesters. At 26 weeks of gestation 27.2% of pregnant patients with PCOS had a notch on either side, comparing with 12.8% of the control group. The rate of adverse pregnancy outcomes was significantly higher in pregnant patients with PCOS 45% versus 10% in the control group.ConclusionsUterine artery Doppler indices have a higher predictive value for abnormal pregnancy outcomes in pregnant patients with PCOS.