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Polycystic ovary syndrome - Management
How do I manage a woman who has PCOS and is pregnant?
- Screen all women with known polycystic ovary syndrome (PCOS) before 20 weeks' gestation, for gestational diabetes and impaired glucose tolerance, with an oral glucose tolerance test.
- Refer the woman to a specialist obstetric diabetic service if abnormalities are detected.
- Be aware that:
- The risks of pregnancy-induced hypertension, pre-eclampsia, and pre-term birth are increased.
- Women with PCOS have a higher rate of spontaneous miscarriage after assisted reproduction.
- Consider whether any changes to drug treatment should be made. For example:
- Metformin is not recommended in pregnancy. Seek specialist advice.
- Any hormonal treatment (such as medroxyprogesterone for inducing cyclical bleeding) should be stopped.
- Eflornithine cream (for hirsutism) is contraindicated in pregnancy.
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