Jamal Ashraf, Milani Forozan, Al-Yasin Ashraf
Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran.
Reproductive Health Research Center, Department of Obstetrics and Gynecology, Alzahra Hospital, Guilan University of Medical Sciences, Guilan, Iran.
Iran J Reprod Med. 2012 May;10(3):265-70.
Women with polycystic ovary syndrome (PCOS) often are infertile and even if they become pregnant, there are complications with some adverse outcomes. It has been reported that aspirin and metformin improve uteroplacental circulation and reduce pregnancy complications.
To determine and compare uteroplacental circulation and obstetrics complications in pregnant women with PCOS treated with metformin, aspirin and control group.
105 pregnant women with PCOS were enrolled in this study after assessing uterine artery pulsatility index (PI) with Doppler ultrasonography at 12 weeks of gestation. The patients were divided into three groups and received metformin 2000 mg or aspirin 80 mg daily, or no intervention until the end of pregnancy. PI was assessed for the patients at 20 week of gestation and groups were followed up till delivery. PI and obstetrics complications such as gestational diabetes, preterm labor, preeclampsia and IUGR were compared among groups.
All groups had significant reduction in the mean uterine artery PI at 20 weeks measurement (p<0.05), but this reduction was more in metformin and aspirin groups than control group (p=0.002). There was a significant difference in mean uterine artery PI 20 week of gestation in three groups (p=0.005). Adverse outcomes have seen 4 out of 35 in metformin group, 7 out of 35 in aspirin group and 11 out of 35 in control group. There weren't significant differences among groups (p=0.12).
Metformin and low dose aspirin reduced uterine artery impedance but there was not associated with reduced obstetrics complication in women with PCOS.
多囊卵巢综合征（PCOS）女性常不孕，即便怀孕，也会出现一些不良结局的并发症。据报道，阿司匹林和二甲双胍可改善子宫胎盘循环并减少妊娠并发症。
确定并比较接受二甲双胍、阿司匹林治疗的PCOS孕妇及对照组的子宫胎盘循环和产科并发症。
105例PCOS孕妇在妊娠12周时通过多普勒超声评估子宫动脉搏动指数（PI）后纳入本研究。将患者分为三组，分别每日服用2000 mg二甲双胍或80 mg阿司匹林，或直至妊娠结束不进行干预。在妊娠20周时评估患者的PI，并对各组进行随访直至分娩。比较各组的PI及产科并发症，如妊娠期糖尿病、早产、子痫前期和胎儿生长受限。
在20周测量时，所有组的平均子宫动脉PI均显著降低（p<0.05），但二甲双胍组和阿司匹林组的降低幅度大于对照组（p=0.002）。三组在妊娠20周时的平均子宫动脉PI存在显著差异（p=0.005）。二甲双胍组35例中有4例出现不良结局，阿司匹林组35例中有7例，对照组35例中有11例。各组之间无显著差异（p=0.12）。
二甲双胍和低剂量阿司匹林可降低子宫动脉阻抗，但与PCOS女性产科并发症的减少无关。
