Pregnancy outcomes after laparoscopic ovarian drilling in women with polycystic ovarian syndrome

OBJECTIVE: To study whether there is an increased risk of glucose intolerance and hypertensive complications during pregnancy in women with polycystic ovarian syndrome (PCOS) who conceived after laparoscopic ovarian drilling and to investigate if there is an adverse pregnancy outcome.

METHODS: This prospective study took place at Salmaniya Medical Complex in Bahrain, between June 1996 and June 2003. We compared the pregnancy and neonatal outcomes of 134 patients with PCOS who were treated with laparoscopic ovarian drilling with 479 pregnant women without PCOS (controls). We used the multiple logistic regression analysis to assess the risk of PCOS on impaired glucose tolerance (IGT), gestational diabetes mellitus (GDM), hypertensive disorders in pregnancy (HDP) and premature delivery.

RESULTS: Subjects with PCOS had a significantly greater prepregnancy body mass index, prevalence of obesity and nulliparity as compared with controls. The incidence of IGT (p=0.007), GDM (p=0.01) and HDP (p=0.001) were significantly higher in pregnant PCOS compared with the control group. There were no significant differences in the neonatal outcomes and prevalence of premature delivery between the 2 study groups. When non-obese PCOS patients were compared with non-obese controls, the incidence of GDM (p=0.04) and HDP (p=0.004) were still significantly higher in the former. The prevalence of pregnancy complications were not significantly different when obese PCOS were compared with obese control patients. The PCOS was demonstrated as a risk factor for IGT (p=0.05), GDM (p=0.03) and HDP (p=0.03), but not for premature delivery.

CONCLUSION: Women with PCOS who conceived after the drilling were at higher risk of IGT, GDM and HDP, and this risk seemed to be independent of maternal obesity.