Care of The Client With Polycystic Ovarian Syndrome During Postpartum Period

Care of the Client with
Polycystic Ovarian
Syndrome during
Postpartum Period
1.
Polycystic Ovarian
Syndrome
2
Introduction
Polycystic Ovary Syndrome

 PCOS, also known as Stein-Leventhal syndrome
 The most frequent cause of ovulation failure seen today.Found in
about 10% of women of childbearing age.
 Adolescents with the syndrome begin to develop an increased androgen
level, which then prevents follicular ovarian cyst from maturing, a
situation that leads to typical symptoms of irregular or missed
menstrual cycle, acne, excessive hair growth (Hirsutism),being
overweight, male pattern baldness, type 2 diabetes and most
important an absence of ovulation.
 The androgen increase is usually directly related to obesity and
further exacerbates insulin resistance (Spritzer & Motta, 2015).
3
 Assessment for the disorder includes a thorough history and
physical exam, a pelvic exam to determine the consistency and
size of ovaries, and perhaps an ovarian ultrasound for the
same purpose.
 Serum androgen and glucose levels will also be assessed.
 Because the exact cause of polycystic ovaries is not known,
treatment is aimed at relieving the symptoms.
 Many adolescents with the syndrome are obese, therefore,
weight loss by increasing lean meet, fruits, and vegetables
and decreasing the amount of concentrated carbohydrates in
their diets is encourage.
4
 These eating pattern also lowered blood glucose levels,
improves the body’s use of insulin, and helps to normalize
testosterone secretion.
 If a woman is morbidly obese, bariatric surgery may be
recommended because this will achieve the same result.
 A COC may be prescribe because this changes the ratio of
estrogen and testosterone produced, leading to better
regulated menstrual cycles.
 To prevent type 2 diabetes from developing, Metformin
(Glucophage) may be prescribe, which is yet another method to
reduced blood glucose levels.
5
 If the adolescent or woman wants to become pregnant,
fertility medications such as a course of clomiphene
(Clomid) to stimulate ovulation may be suggested.
 Two final therapies to help achieved pregnancy are in vitro
fertilization and ovarian drilling a surgery technique done
by laparosvopy that reduces the size of the ovaries and
limits the amount of testosterone the ovaries are able to
produce.
6
2.
Risks for moms-to-be
with PCOS
7
◍ Having PCOS might make it harder for you to get pregnant.
Hormonal imbalances might be to blame.
◍ Women with PCOS are more likely to be obese and to rely
on reproductive technology to get pregnant. One study
found that 60 percent Trusted Source of women with PCOS
are obese. Almost 14 percent required reproductive
technology to get pregnant.
8
Women with PCOS have an increased risk of developing several
medical complications throughout life, including:
◍ insulin resistance
◍ type 2 diabetes
◍ high cholesterol
◍ high blood pressure
◍ heart disease
◍ stroke
◍ sleep apnea
◍ possibly an increased risk of endometrial cancer
9
For pregnant women, PCOS brings an increased risk of
complications. This includes preeclampsia, a dangerous
condition for both mother and baby-to-be. The recommended
treatment to resolve symptoms is delivery of the baby and
placenta. Your doctor will discuss the risks and benefits
regarding timing of delivery based on the severity of your
symptoms and your baby’s gestational age. If you develop
preeclampsia during your pregnancy, you will have to be
monitored extremely closely. Other concerns include
pregnancy-induced hypertension (high blood pressure) and
gestational diabetes.
10
Getting pregnant with PCOS
◍ Some women may not realize they have PCOS until they
try to conceive. PCOS often goes unnoticed. But if
you’ve been trying to conceive naturally for over a
year, you should speak to your doctor about getting
tested.
◍ Your doctor can help you develop a plan for getting
pregnant. Some strategies, such as losing weight,
healthy eating, and in certain cases, medications, can
increase your chances for getting pregnant.
11
◍ Breast-feeding has many benefits for both you and your
baby, so if it fits your family, be sure to explore the
options and available resources so you can have a
successful breast-feeding experience.
12
Postpartum Period
◍ The postpartum period is one of great change for all women, and
there are barriers that may make weight loss difficult,
particularly in women with PCOS, such as urinary incontinence,
appetite dysregulation and poor mental health or quality of life.
Women with PCOS experience poor quality of life and depression,
but the association with weight management and specifically post-
partum weight retention is not known. Additionally, incontinence
has not been studied in PCOS, and not in the postpartum period.
Women with incontinence also have higher levels of depression and
lower quality of life, and we have previously found that there is
an additive affect, which affects both physical and mental health.
13
14
Postpartum Period
◍ Cardiometabolic and psychiatric are complications in the

postpartum period. According to results from a prize
paper at the annual meeting of the American Society for
Reproductive Medicine.
◍ Women with PCOS should be considered a high-risk group,
and during the postpartum period should be screened for
cardiovascular as well as psychiatric comorbidities -
Anuja Dokras, MD, PhD,
15
◍ Dr. Dokras and colleagues performed a retrospective
cohort study during 2000-2016 of patients aged 18-50
years, in the Optum claims database, which comprised
42,391 women with PCOS and 795,480 women without PCOS in
50 U.S. states.
◍ The researchers looked at risk factors prior to
pregnancy, such as depression, hypertension,
hyperlipidemia, diabetes, obesity, smoking, and use of
assisted reproductive technology.
16
◍ During pregnancy, Dr. Dokras and colleagues analyzed
complications such as preterm birth, multiple gestation,
cesarean section, gestational hypertension and diabetes,
preeclampsia and eclampsia, and depression in addition
to outcomes in the postpartum period, such as
hypertensive complications, thrombotic disease,
peripartum cardiomyopathy, heart failure, arterial
complications, perinatal and postpartum depression.
17
◍ For patients in the postpartum period, women with PCOS
were more likely to experience postpartum thrombotic
disease, hypertensive heart disease, eclampsia, heart
failure, preeclampsia, and peripartum cardiomyopathy.
◍ With regard to depression, women with PCOS also were at
greater risk of developing perinatal and postpartum
18
PCOS and breast-feeding
◍ Women with PCOS appear to have a reduced breastfeeding rate in

the early postpartum period. Possibly, gestational
dehydroepiandrosterone-sulphate might negatively influence
breastfeeding rate in women with the syndrome
◍ If you’re diagnosed with PCOS, you may need to continue to manage
symptoms even after pregnancy. But symptoms and severity can vary.
Sometimes the hormonal fluctuations after pregnancy and breast-feeding
can change the symptoms, so it may be awhile before you settle into
your new “normal.”
◍ It’s safe to breast-feed with PCOS, even if you’re on insulin
medication to help control your blood sugar. Women who have
gestational diabetes are at risk for developing type 2 diabetes later
in life, but breast-feeding can help lower that risk.
19
Managing PCOS postpartum
◍ There is no treatment for PCOS. It can only be managed

symptomatically. Depending on how PCOS is affecting a
woman s postpartum life a plan can be chalked out.
However, losing weight postpartum is crucial. Weight
loss in PCOS helps to bring some semblance in the
hormonal cycles. If there is an underlying condition
like thyroid or diabetes that fuels the condition then
those health issues need to be treated to reduce the
effect of PCOS and its symptoms, says Dr Gajraj.
20
👍
Thanks!
21
Refferences
◍ Maternal and Child Health Nursing Book

o https://www.healthline.com/health/pregnancy/pcos#next-steps
o https://www.mdedge.com/obgyn/article/210463/obstetrics/women-pcos
-have-greater-risk-postpartum-depression-preeclampsia
o https://www.ncbi.nlm.nih.gov/m/pubmed/18446536/
o https://www.thehealthsite.com/diseases-conditions/pcos/what-happe
ns-to-your-pcos-after-pregnancy-d0718-582753
/
o http://pcos-cre.edu.au/barriers-to-reduce-postpartum/
22

Care of The Client With Polycystic Ovarian Syndrome During Postpartum Period

Uploaded by

Copyright:

Available Formats

Care of The Client With Polycystic Ovarian Syndrome During Postpartum Period

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Care of The Client With Polycystic Ovarian Syndrome During Postpartum Period

Uploaded by

Copyright:

Available Formats

Care of the Client with

Polycystic Ovary Syndrome

◍ Cardiometabolic and psychiatric are complications in the

◍ Women with PCOS appear to have a reduced breastfeeding rate in

◍ There is no treatment for PCOS. It can only be managed

◍ Maternal and Child Health Nursing Book

You might also like