Uterine blood flow in pregnant patients with polycystic ovary syndrome: relationships with clinical outcomes.
OBJECTIVE
To study the impedance to blood flow through the uterine artery in pregnant women with polycystic ovary syndrome (PCOS), and to evaluate its predictive value for adverse pregnancy and perinatal outcomes in this population.


METHODS
Prospective case-control study.


METHODS
Academic Departments of Obstetrics and Gynaecology in Italy.


METHODS
Seventy-three pregnant women with ovulatory PCOS (PCOS group) and 73 age- and body mass index-matched healthy pregnant controls (control group).


METHODS
Serial Doppler velocimetry measurements of the uterine artery.


METHODS
Blood flow impedance indices and pregnancy/perinatal outcomes.


RESULTS
A significantly (P < 0.05) higher rate of subjects with abnormal velocimetry findings was observed in the PCOS group than in the control group. In the PCOS group, the pulsatility index (PI) at first (P = 0.042) and mid-second (P = 0.039) trimesters of pregnancy, and bilateral notch at first (P = 0.025) and mid-second (P = 0.007) trimesters of pregnancy, were the strongest independent predictors of adverse outcomes. Conversely, in the control group, PI at the first trimester of pregnancy was a predictor of adverse outcomes only when combined with bilateral notch (P = 0.042), whereas at mid-second trimester of pregnancy PI (P = 0.033) and bilateral notch (P = 0.048) were independent predictors of adverse outcomes.


CONCLUSIONS
Uterine artery Doppler indices are more commonly altered in pregnant patients with PCOS than in controls, showing a high predictive value for abnormal pregnancy/perinatal outcomes.
Department of Obstetrics & Gynaecology, University Magna Graecia of Catanzaro, Catanzaro, Italy. stefanopalomba@tin.it
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S
Palomba
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Falbo
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Russo
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L
Battista
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Tolino
F
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Orio
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Zullo
D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D011446:Prospective Studies; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods; D016216:Ultrasonography, Prenatal / Q000379:methods; D055988:Uterine Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014599:Uterus / Q000098:blood supply*; D014655:Vascular Resistance / Q000502:physiology; D055815:Young Adult