Premium
Metformin treatment in pregnant women with polycystic ovary syndrome—is reduced complication rate mediated by changes in the uteroplacental circulation?
Author(s) -
Salvesen K. Å.,
Vanky E.,
Carlsen S. M.
Publication year - 2007
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.3965
Subject(s) - medicine , polycystic ovary , uterine artery , pregnancy , gestation , metformin , umbilical artery , preeclampsia , obstetrics , gestational age , placebo , gestational hypertension , gynecology , insulin resistance , obesity , alternative medicine , pathology , biology , insulin , genetics
Abstract Objectives To study a possible effect of metformin on the uteroplacental circulation. Methods Forty pregnant women with polycystic ovary syndrome (PCOS) were enrolled in a randomized, double‐blind, placebo‐controlled trial of metformin (1700 mg/day) during pregnancy. Doppler ultrasound examinations of the uterine arteries were performed at 12, 19, 24, 32 and 36 gestational weeks and of the umbilical artery at 19, 24, 32 and 36 gestational weeks. Results There was a greater mean bilateral uterine artery pulsatility index (PI) at 12 weeks (1.95 vs. 1.58, P = 0.02), and a greater reduction in mean PI from 12 to 19 weeks ( P = 0.03) in metformin‐treated women. There were no differences in mean PI values between groups at 19, 24, 32 or 36 gestational weeks. Pregnancy complications, such as preterm delivery before 32 weeks, severe pre‐eclampsia or serious postpartum events, occurred only in the placebo group (7 of 22 vs. 0 of 18, P = 0.01). There were no associations between uterine artery Doppler measurements and pregnancy complications. We found no differences between groups in mean umbilical artery PI at 19, 24, 32 or 36 gestational weeks. Conclusions In this small randomized trial, metformin treatment in pregnancy reduced uterine artery impedance between 12 and 19 weeks of gestation, and this was associated with reduced complication rate. Copyright © 2007 ISUOG. Published by John Wiley & Sons, Ltd.