Frequency Of Preterm Labor Research Articles

Vaginal and oral probiotics effect in the prevention of preterm delivery in patients visiting Kamali Hospital, Karaj, Iran in 2020.

IntroductionThe prevalence of preterm labor (PTL) is growing, and annually one in ten babies is born prematurely. Various studies have examined the effect of oral or vaginal probiotics on the prevention of preterm labor, which has yielded contrasting results. This study aimed to compare the impact of vaginal and oral probiotics on the prevention of preterm delivery.MethodsThis clinical trial was performed among 185 pregnant women with a gestational age greater than or equal to 25 weeks visiting Kamali Hospital, Karaj, Iran in 2020. The participants were divided into three groups; intervention group 1 receiving Oral probiotic pill once a day until 37 weeks of pregnancy, intervention group 2 receiving probiotic vaginal suppository once a day until 37 weeks of pregnancy, and control group not receiving any intervention. Patients were then followed up until the end of pregnancy.ResultsDemographic characteristics and gestational age at the time of intervention were not significantly different among the three groups. Overall, 26.7 % in the control group, 30 % in intervention group 1 %, and 22.5 % in intervention group 2 had deliveries less than 37 weeks. There was no significant difference in the frequency of preterm labor and the duration of pregnancy among the groups (all p > 0.05).ConclusionProbiotics use does not increase the rate of preterm delivery or reduce the duration of pregnancy, but the rate of preterm delivery was lower in the oral probiotic group. Further clinical studies on the impact of probiotics on PTL can yield valuable results.

The comparison of predictive value of cervical length in singleton spontaneous preterm labor with in vitro fertilization pregnancies: A cohort study.

Background Preterm labor (PTL) is one of the most important factors in neonatal mortality. Some studies have revealed a reverse relationship between cervical length (CL) and PTL, however, further evidence is needed to confirm it.ObjectiveTo investigate the predictive value of CL in spontaneous and in vitro fertilization (IVF) pregnancies.Materials and MethodsThis prospective cohort study was performed on 154 pregnant women from 16-26 wk of gestation with singleton fetus in spontaneous delivery (n = 77) and IVF pregnancies (n = 77) and followed up until delivery. Women with multiple pregnancy, placenta previa, cerclage, and congenital anomalies were excluded from study. The cut-off determination was done according to the Roc analysis.ResultsThe mean CL in term delivery and PTL groups were 37 7 mm and 31 6 mm, respectively (p 0.001). The frequency of PTL in spontaneous and IVF pregnancies were 7.8% and 23.27%, respectively (p = 0.007). According to the Roc analysis, the best cut-off for normal pregnancy was 36 mm with the negative predictive value of 97.9%, the positive predictive value of 11.4%, sensitivity 83.3%, and specificity of 46.5%. While for the IVF group, the cut off was 30 mm, with a negative predictive value of 88.4%, positive predictive value of 57.8%, sensitivity of 63.2%, and specificity of 86%.Conclusion In this study, IVF had a significant direct correlation with PTL. CL also had a significant indirect relationship with PTL.

Extragenital Pathologies of Pregnant Women in the Southern Regions of The Republic of Kazakhstan

The main priorities of the health care system is to strengthen the health of pregnant women and child. Currently, risk factors pregnancy include age, first pregnancy, multiple pregnancies, genetic factors, endocrine system pathology, social aspects, occupational hazards etc. The purpose of our study is to study the prevalence of extragenital pathology in pregnant women in the southern regions of Kazakhstan. Methods: As part of the study, the facilities were obstetric services in Almaty, Zhambyl, Kyzylorda, South Kazakhstan oblasts and the city of Almaty. The subject of the study was the indicators of the activities of obstetrical health organizations in the southern regions of the country from 2012 to 2016. The materials of the study were dynamic indicators of the activities of inpatient obstetric health care organizations (frequency of preterm labor, bleeding, surgical interventions, etc.) for 2012 to 2016. Statistical data processing was carried out using Excel. Results: Comparative studies have shown that the incidence of kidney and urinary tract diseases is the highest among all extragenital diseases accompanying pregnancy. The results may indicate a lack of female consultations to identify and treat major endocrine diseases before pregnancy, early pregnancy, and the need for more intensive monitoring of compliance with clinical protocols for pregnancy management aimed at limiting perinatal risks for the mother and fetus. Conclusion: There is a need to strengthen the work of the primary link to the issues of early detection, comprehensive diagnosis and quality treatment to minimize perinatal risks for pregnant women and the fetus.

Efficacy of daily rectal micronized progesterone for prevention of preterm delivery: a randomized clinical trial

Introduction Preterm delivery is the leading cause of neonatal morbidity and mortality and its prevention is always under serious concern. Objective The aim of the present study was to determine the efficacy of rectal progesterone as a maintenance tocolytic after arresting preterm labor, for increasing the duration of pregnancy, and postponing preterm birth. Method The study was performed as a double blind randomized clinical trial on women with preterm labor in whom contractions have been stopped. The eligible women were randomly divided into two groups. In the intervention group (progesterone group), progesterone was administered rectally as a dose of 200 mg daily until 36+6 weeks or spontaneous delivery before that time, whichever came first; and in the placebo group, placebo was administered in a similar manner. Primary outcomes were number of deliveries before 37 weeks of gestation and time to delivery interval in two groups. Secondary outcomes were neonatal Apgar score and weight, and need for NICU admission. Results 160 women finished the study (80 women in each group). The women of the two groups did not have significant difference according to the baseline characteristics. Frequency of preterm labor (earlier than 37 weeks) and mean gestational age at the time of delivery did not show significant difference in two groups. Also, neonatal outcome including Apgar score, birth weight, NICU admission and neonatal complications were not different between the two groups. The pregnancy length was longer in progesterone group (28.84 ± 3.36 VS 21.19 ± 4.62 days), [p = .001, CI 95%: 3.71–4.83]. The time-to-event (delivery) analysis showed a hazard ratio of 1.02 (95% CI 0.36–2.77). Conclusion Rectal progesterone at a daily dose of 200 mg as a maintenance tocolytic agent, cannot lower the frequency of preterm delivery but was suggested to prolong pregnancy length.

THE STATE OF THE BLOOD COAGULATION SYSTEM IN PREGNANT WOMEN WITH THE THREAT OF PRETERM BIRTH WHEN USING METABOLIC THERAPY

Introduction. The frequency of preterm labor is remained unchanged for many years, despite numerous studies. The perinatal mortality rate of premature babies is almost 30 times higher compared with babies born at term. Changes in the hemostatic system during pregnancy (increased blood clotting) lead to the formation of microthrombus and hematoma in the vessels of the placenta, which impair blood circulation in it. Aim. To assess the state of hemostasis in pregnant women with the threat of premature birth, who received metabolic therapy and those who did not receive it. Material and methods.Clinical and laboratory examination of 130 pregnant women was carried out: I group – 67 pregnant women with threatened preterm labor who received standard integrated basic therapy in combination with metabolic therapy in the form of 300 mg of omega-3 PUFA per day was conducted, group II - 63 pregnant women with the threat of premature birth who received only standard complex basic therapy. To assess the effectiveness of the proposed therapy, hemostasis indicators were studied. Research results. The paper presents the results of the use of metabolic therapy in the complex treatment of the threat of preterm labor, which testify to its effectiveness, which contributed to the improvement of the rheological properties of blood. After the proposed therapy, in women who took metabolic therapy, the level of thrombocytes increased, fibrinogen and antithrombin III decreased, activated partial thromboplastin time increased, in contrast to the indicators of the group of women who did not take it. The frequency of preterm birth decreased by 1.5 times (58.2% versus 82.5%) and perinatal outcomes improved.Conclusions.The use of metabolic therapy in the complex treatment of the threat of preterm labor indicates it effectiveness and has contributed to the improvement of perinatal outcomes.

Modern tocolysis and adverse effects of tocolytics

Relevance. Toсolytic therapy is the only method that is used in the treatment of pregnant women with preterm labor. However, the effectiveness and safety of this therapy is still a matter of debate. One of the least studied issues of this problem is the safety of therapy, which is primarily manifested by the frequency of side effects. The aim is to carry out a comparative study of the safety of the most common tocolytic agents - atosiban, nifedipine and hexoprenaline sulfate. Material and methods. The study included 173 pregnant women with threatening premature births in a period of 28 to 34 weeks. In 54 cases, tocolysis with nifedipinum, 57 with atosiban, 62 with hexoprenaline was performed. To assess the effectiveness of tocolysis, clinical and instrumental methods of control (ultrasound with cervicometry) were used. The primary outcome points were the frequency of prolongation of pregnancy at 48 h and the incidence of side effects, including those requiring the termination of tocolysis. Results. Prolongation of pregnancy at 48 h was achieved in groups of nifedipine, atosiban and hexoprenaline sulfate, respectively in 46 (85.19%), 55 (96.49%) and 53 (77.40%) pregnant. Atosiban showed significantly higher efficacy. In 8 cases of tocolysis with nifedipine and 3 - hexoprenaline, the tocolysis protocol was not performed due to intolerance of treatment. In these observations, the highest frequency of preterm labor occurred. After excluding these observations from the analysis of differences in the frequency of prolongation of pregnancy was not. The overall frequency of adverse events in the groups was 38.9, 12.3 and 82.3%, and was significantly lower in the atosiban group than nifedipine and hexoprenaline sulfate. Conclusions. The effectiveness of tocolysis is affected by the tolerability of the drugs. Atosiban showed the best of the three drug safety profile. With comparable efficacy, atosiban has proven to be a drug that, to a greater extent than nifedipine and hexoprenaline sulfate, meets the current requirements for tocolytic drugs.

Профілактика передчасних пологів у жінок із доброякісною патологією шийки матки в анамнезі

The article presents the prophylactic and therapeutic complex developed by us, which reduces the frequency of early and late spontaneous abortions, premature births, reduces placental dysfunction, anomalies of labor, fetal distress, the percentage of cesarean sections, the pathology of the postpartum period in women with benign pathology of the cervix ) in the anamnesis. The objective: was to decrease the frequency of preterm labor in women with benign pathology of CM in the anamnesis on the basis of studying clinical and microbiological and endocrinological features, as well as using the developed complex of preventive and curative measures. Materials and methods. The study was conducted in two stages. At the first stage, the features of the course of pregnancy, childbirth, the postnatal and neonatal periods were studied in 50 patients with a benign pathology of CM in a history, which was carried out by conventional preventive and therapeutic measures (first group); for the comparative characteristics, similar parameters were studied in 50 obstetric and somatically healthy primiparas (control group). At the second stage, clinical and instrumental-laboratory evaluation of the prophylactic-therapeutic complex developed by us was carried out, which was used before and during pregnancy in 50 women with a benign pathology of CM in the anamnesis (II main group). Results. The use of the proposed treatment-and-prophylactic complex prevented recurrence of benign pathology of CM by results of colposcopic and cytological studies – 26% in the 2-nd main group against 62% in the I primary group (p<0.05). No cases of prematurity or perinatal death in newborns from mothers assigned to the prophylactic-therapeutic complex proposed by us have been recorded. Сonclusion. The prophylactic and therapeutic complex developed by us includes the use, starting from early pregnancy, of natural micronized progesterone, diosmin, succinic acid, levocarnitine and a local antiseptic with probiotic, which allows reducing the frequency of preterm birth and other obstetric and perinatal complications. This helps to improve the results of delivery in women with benign cervical pathology in history. Key words: pregnancy, childbirth, benign pathology of the cervix, fetoplacental complex.

Selection of the method for correction of cervical incompetence

Cervical incompetence (CI) is one of the challenges of modern obstetrics. The practicing obstetrician-gynecologist faces a complex task of timely diagnosis, selection of correction method, timing of application and removal of cerclage. The problem of CI in pregnancy is known from the XIX century, but in the XI century, the outstanding scientist Abu Ali Ibn Sina (Avicenna) wrote about this pathology. According to the classical definition, CI is the softening, widening and shortening of the cervix prior to the 37th week of gestation in the absence of thretening termination of pregnancy. CI is characterized by inability to carry a pregnancy to full-term due to functional or structural abnormalities of the uterine cervix. To date, no objective diagnostic tests exists to identify patients at high risk of developing CI, not before and not during pregnancy. A high diagnostic accuracy during pregnancy can be reached with transvaginal ultrasound of the cervix. The ultrasound scale proposed by Salomon LJ allows to measure the length of the cervix depending on the gestational age and assists in making the right choice for the correction of short cervix. The selection of the method of correction of CI depends on the clinical situation, history, timing of gestation, the number of fetuses, cervicometry data, gynecological examination, the threat of abortion, and the doctor’s experience. There are two main methods of correction of CI: conservative and surgical. Surgical methods include transvaginal and transabdominal cerclage, while conservative includes adherence to bed rest, tocolytics, hormonal therapy, and the use of obstetric pessaries. Insertion of obstetric pessaries is a promising, safe, simple method of treatment and prevention of CI and for threatening termination of pregnancy in the II and III trimesters. The strategy of widespread use of pessaries in pregnant women from high-risk groups can reduce the frequency of preterm labor and improve perinatal outcomes.

Антифібринолітична терапія у клініці невиношування вагітності – аспекти лікувальної тактики

The objective: to evaluate the efficacy of tranexamic acid (Tranexam drug) accompanied by pregnancy with a partial detachment of a normally located placenta in the second trimester of pregnancy in women with a history of obstetrical gynecological anamnesis. Patients and methods. Under observation were 75 patients with complicated retrochorial hematoma at first trimester of pregnancy, re-hospitalized at the time of 18–21 weeks with signs of premature placental abruption. The blind method of the patient was randomized into two groups (baseline and comparison), which differed in the type of haemostatic therapy. Clinical groups were formed by age (26.5±0.8 and 27.4±1.1 years, respectively), parity, gestational age, somatic and obstetric-gynecological history, localization and approximate sizes of retroplacental hematomas were comparable. Patients from both groups received sublingual micronized progesterone at a dose of 200 mg, anti-anemia and symptomatic therapy according to indications. In the main group, 45 pregnant women received a haemostatic therapy with the drug Tranexam (Stada): 750 mg at a single dose at a single dose of 1500 mg for 5 to 7 days before bleeding stopped. 30 patients, who underwent haemostatic therapy with sodium etamzilate in a complex of therapeutic measures, made a comparison group. The duration of hemorrhage from the genital tract, the regression of the retrohorial hematoma, the length of stay in the hospital, the prolongation and the consequences of pregnancy were estimated. Results. Clinically, a decrease in the intensity of bleeding with Tranexam was observed 24.6±2.1 hours after the initial dose, bleeding duration averaged 3.5±0.3 days, whereas in the group taking sodium etamzilate, the bleeding time was significantly longer – 4.9±0.2 days (p<0.05). These data correlated with ultrasound data confirming the absence of progression of retrochorial hematomas from the second day with the use of Tranexam in 34 (75.6%) of the women in the main group, whereas in the comparison group, similar changes occurred at the same time in only 10 (33.3%) of patients (p<0.5). The faster stopping of bleeding and, as a consequence, the organization and resorption of hematomas in the region of placental detachment in a shorter period affected the effects of pregnancy (the frequency of preterm labor in the comparison group occurred 2.2 times more often than in the main group). Conclusion. Taking into account the peculiarities of the physiological mechanisms of the functioning of the fibrinolytic system during the gestation period and the significance of their disturbances in the genesis of early and late gestational bleeding allows us to choose the most effective therapeutic tactics. Tranexam in effective daily doses with course duration of treatment of 5–7 days gives a pronounced haemostatic effect, does not cause side effects, and allows successfully prolonging the pregnancy and reducing the frequency of late gestational complications. Inclusion in the treatment complex of patients with recurrence of retroplacentar hematomas and formation of partial placental detachment in the second trimester of gestation of the preparation of antifibrinolytic action to Tranexam is an effective means not only to stop bleeding, but also to preserve pregnancy, prevent the formation of placental insufficiency and ensure favorable pregnancy outcomes. Accumulated experience allows attributing Tranexam to the drugs of the first choice in the clinic for miscarriage and recommending it for widespread use in practice. Key words: retroplacentar hematoma, pregnancy, antifibrinolytic therapy, Tranexam.

PECULIARITIES OF ANAMNESIS AND COMPLICATIONS OF PREGNANCY IN THE I-II TRIMESTERS AND PRETERM BIRTH RISK

Aim. Assess the significance of anamnestic data and complications of gestation in I-II trimesters in predicting PL depending on the gestational age. Materials and methods. A prospective comparative study was carried out at the clinical bases of the Department of Obstetrics, Gynecology and Perinatology of postgraduate education of the Kuban State Medical University (Krasnodar): in the Perinatal Centers of the Children's Regional Clinical Hospital (DKKB) and the Regional Clinical Hospital No. 2 (KKB No. 2). The perinatal center of theRegionalClinicalHospital "DKKB" (Krasnodar) is specialized in premature birth in theKrasnodarTerritory. Women with preterm labor (ICD code-O60) included in the study were divided into four groups included depending on the gestational age: very early premature births (22-276days, n = 37 women), early premature births (28-306 days) weeks, n = 40 women), premature birth (30-336 days, n = 38 women), late premature birth (33-366 days, n = 35 women). The control group consisted of conditionally healthy women with a full term of pregnancy and with physiological births (37- 403 days of weeks, n = 50). Results. The importance of pregnancy complications in I-II trimesters as risk factors for premature birth was established. Prophylaxis, timely diagnosis and treatment of these complications may be a measure of a decrease in the frequency of PL, or an increase in the duration of pregnancy with PL. Conclusion. Prophylaxis, timely diagnosis and treatment of these complications may be a measure of a reduction in the frequency of preterm labor or an increase in the duration of pregnancy in preterm labor.

The Relationship between Maternal Employment Status and Pregnancy Outcomes.

Background and Objectives:Women comprise a large percentage of the workforce in industrial countries. In Europe and many other places in the world, women of reproductive age comprise a significant proportion of the workforce at the workplaces, and the rules and regulations require employers to evaluate and minimize health risks to pregnant women. In U.K, 70%, and in the United States 59% of women are employed. In Iran, 13% of women are employed, which comes down to less than 5% at Sistan& Baluchestan Province. Various studies have reported contradictory results about the effects of maternal employment tasks such as standing, repetitive bending, climbing stairs, and lifting heavy objects during pregnancy on fetal growth, preterm birth and other obstetric complications. Given the growing number of working women, and potential complications for mothers, the present study has conducted to investigate the relationship between maternal employment status and pregnancy outcomes in Zahedan city, Iran.Materials and Methods:This cross-sectional study was based on survey conducted on 227 women (121 housewives, and 106 employed women) attending health centers in 2014. Using purposive convenient sampling method, eligible pregnant mothers (with no chronic diseases, singleton pregnancy, gravida 1-3, and no addiction) were selected as study subjects. Data were collected and recorded through a researcher-made questionnaire and also from mothers’ medical records, including personal details, prenatal and labor complications, and infant’s details. Collected data were fed into the SPSS version 21(IBM Corp, USA).Results:Frequency of placental abruption was greater among housewives (P=0.02), and a significant relationship was found between employment status and lifting heavy objects, which was more frequent among housewives (P=0.01). Lifting heavy objects during pregnancy was only significantly related to reduced amniotic fluid (P=0.001) and low birth weight (P=0.01). Frequency of preterm labor was higher among housewives compared to employed women, but not significantly. Type of delivery was significantly related to employment, and employed mothers had more cesarean deliveries (P=0.0001).Conclusion:The results suggest more frequent lifting of heavy objects by housewives than by employed mothers, leading to increased complications such as reduced amniotic fluid, placental abruption, and low birth weight. Perhaps due to higher education levels, frequency of cesarean section and preterm labor was higher among employed mothers. However, employment alone does not predict pregnancy outcomes.

Factors associated with preterm delivery in women admitted to hospitals in Khorramabad: A case control study

Background: Preterm birth is the leading cause of neonatal mortality and a major public health concern. This study aimed to determine factors influencing preterm labor in women referring to hospitals in Khorramabad in 2009-10. Materials and Methods: This case-control study was conducted on 524 mothers (262 subjects in each group) referring to hospitals in Khorramabad (west of Iran) in 2009-10, selected through consecutive sampling. A questionnaire was completed through interviews for each newborn after being examined. Collected data, were analyzed by using the logistic regression and odds ratios and a significant level of 5%. The logistic regression model sensitivity in detecting cases of preterm labor was 86%. Results: The frequency of preterm labor in mothers under 20 was 5.83 times higher than that in mothers in the age range of 20-35 (CI=2.99, 11.37, and P < 0.001). The odds ratios for preterm birth were highest for multiple pregnancies and preterm delivery in mothers with a history of obstetric complications as preterm delivery, low birth weight, stillbirth and abortion is seen more than that in other mothers. Conclusion: These findings will be useful for medical staff and public health workers in attempting to identification and management of risk factors and unfavorable social environment and provide early intervention to reduce the risk of preterm delivery.

Does Continuous Use of Metformin Throughout Pregnancy Improve Pregnancy Outcomes in Women With Polycystic Ovarian Syndrome?

Aim: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies in women of reproductive age. It is associated with hyperinsulinemia and insulin resistance which is further aggravated during pregnancy. This mechanism has a pivotal role in the development of various complications during pregnancy. In the past few years, metformin, an insulin sensitizer, has been extensively evaluated for induction of ovulation. Its therapeutic use during pregnancy is, however, a recent strategy and is a debatable issue. At present, evidence is inadequate to support the long-term use of insulin-sensitizing agents during pregnancy. It is a challenge for both clinicians and researchers to provide good evidence of the safety of metformin for long-term use and during pregnancy. This study aimed to evaluate pregnancy outcomes in women with PCOS who conceived while on metformin treatment, and continued the medication for a variable length of time during pregnancy. Methods: This case-control study was conducted from January 2005 to December 2006 at the antenatal clinics of the Department of Obstetrics and Gynecology, Aga Khan University, Karachi, Pakistan. The sample included 137 infertile women with PCOS; of these, 105 conceived while taking metformin (cases), while 32 conceived spontaneously without metformin (controls). Outcomes were measured in three groups of cases which were formed according to the duration of use of metformin during pregnancy. Comparison was made between these groups and women with PCOS who conceived spontaneously. Results: All 137 women in this study had a confirmed diagnosis of PCOS (Rotterdam criteria). These women were followed up during their course of pregnancy; data forms were completed once they had delivered. Cases were divided into three groups: group A, 40 women who stopped metformin between 4–16 weeks of pregnancy; group B, 20 women who received metformin up until 32 weeks of gestation; and group C; 45 women who continued metformin throughout pregnancy. All the groups were matched by age, height and weight. Comparison was in terms of early and late pregnancy complications, intrauterine growth restriction and live birth rates. In groups A, B and C the rate of pregnancy-induced hypertension/pre-eclampsia was 43.7%, 33% and 13.9% respectively (P < 0.020). Rates of gestational diabetes requiring insulin treatment in groups A and B were 18.7% and 33.3% compared to 2.5% in group C (P < 0.004). The rate of intrauterine growth restriction was significantly low in group C: 2.5% compared to 19.2% and 16.6% in groups A and B respectively (P < 0.046). Frequency of preterm labor and live birth rate was significantly better in group C compared to groups A and B. Overall rate of miscarriages was 7.8%. Controls were comparable to group A in terms of early and late pregnancy complications. Conclusion: In women with PCOS, continuous use of metformin during pregnancy significantly reduced the rate of miscarriage, gestational diabetes requiring insulin treatment and fetal growth restriction. No congenital anomaly, intrauterine death or stillbirth was reported in this study.

Does continuous use of metformin throughout pregnancy improve pregnancy outcomes in women with polycystic ovarian syndrome?

Polycystic ovarian syndrome (PCOS) is one of the most common endocrinopathies in women of reproductive age. It is associated with hyperinsulinemia and insulin resistance which is further aggravated during pregnancy. This mechanism has a pivotal role in the development of various complications during pregnancy. In the past few years, metformin, an insulin sensitizer, has been extensively evaluated for induction of ovulation. Its therapeutic use during pregnancy is, however, a recent strategy and is a debatable issue. At present, evidence is inadequate to support the long-term use of insulin-sensitizing agents during pregnancy. It is a challenge for both clinicians and researchers to provide good evidence of the safety of metformin for long-term use and during pregnancy. This study aimed to evaluate pregnancy outcomes in women with PCOS who conceived while on metformin treatment, and continued the medication for a variable length of time during pregnancy. This case-control study was conducted from January 2005 to December 2006 at the antenatal clinics of the Department of Obstetrics and Gynecology, Aga Khan University, Karachi, Pakistan. The sample included 137 infertile women with PCOS; of these, 105 conceived while taking metformin (cases), while 32 conceived spontaneously without metformin (controls). Outcomes were measured in three groups of cases which were formed according to the duration of use of metformin during pregnancy. Comparison was made between these groups and women with PCOS who conceived spontaneously. All 137 women in this study had a confirmed diagnosis of PCOS (Rotterdam criteria). These women were followed up during their course of pregnancy; data forms were completed once they had delivered. Cases were divided into three groups: group A, 40 women who stopped metformin between 4-16 weeks of pregnancy; group B, 20 women who received metformin up until 32 weeks of gestation; and group C; 45 women who continued metformin throughout pregnancy. All the groups were matched by age, height and weight. Comparison was in terms of early and late pregnancy complications, intrauterine growth restriction and live birth rates. In groups A, B and C the rate of pregnancy-induced hypertension/pre-eclampsia was 43.7%, 33% and 13.9% respectively (P<0.020). Rates of gestational diabetes requiring insulin treatment in groups A and B were 18.7% and 33.3% compared to 2.5% in group C (P<0.004). The rate of intrauterine growth restriction was significantly low in group C: 2.5% compared to 19.2% and 16.6% in groups A and B respectively (P<0.046). Frequency of preterm labor and live birth rate was significantly better in group C compared to groups A and B. Overall rate of miscarriages was 7.8%. Controls were comparable to group A in terms of early and late pregnancy complications. In women with PCOS, continuous use of metformin during pregnancy significantly reduced the rate of miscarriage, gestational diabetes requiring insulin treatment and fetal growth restriction. No congenital anomaly, intrauterine death or stillbirth was reported in this study.