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Pregnant. Have bleeding, have PCOS. On diabetim. Stop medication?

Hello Sir! I'm six weeks pregnant, last week I started bleeding. I was diagonised for polycystic ovary disease and placed on diabetmin tablet for two months.i took the medication for a month and released I'm pregnant so I stopped the medication immediately.i am currently on strict bed rest, please advice me on what to do.
Asked On : Tue, 9 Apr 2013
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Internal Medicine Specialist 's  Response

Thanks for posting your query.

It is better to continue metformin during pregnancy for a women with PCOS.

There are many advantages and disadvantages of taking metformin during pregnancy.
Administration of metformin throughout pregnancy to women with PCOS was associated with a marked and significant reduction in the rate of early pregnancy loss. A smaller prospective pilot study19 in 19 women with PCOS demonstrated a 63% decrease in spontaneous abortions in women treated with metformin.

A prospective observational study of 42 pregnancies in 39 women with PCOS that was published in 2004 demonstrated the effectiveness of metformin in reducing the incidence of gestational diabetes mellitus in this high-risk population.
Study results are as:-
Metformin therapy during conception and continued during pregnancy in 72 oligo/amenorrheic women with PCOS was safely associated with reduction in spontaneous abortion (17% with metformin vs. 62% without) and in GDM (4% with metformin vs. 26% without), was not teratogenic, and did not adversely affect birth weight or height, weight, and motor and social development at 3 and 6 months of life.There was no maternal lactic acidosis, no maternal or neonatal hypoglycemia, and no congenital malformation in live births.

The question of whether to use metformin in the treatment of PCOS remains a hotly debated subject.Benefits overweight than side effects hence better to continue metformin during pregnency with PCOS.
Consult with the endocrinologist regarding management of PCOS and clinical correlation.

Hope this helps you.

Wish you good health.

Answered: Tue, 9 Apr 2013
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OBGYN Dr. Arif N Khan's  Response
Thanks for your query. Looks like its a Threatened Abortion. I feel you should continue METFORMIN, and do consult your gynecologist and get a Ultrasound done for confirmation.

I hope this information has been both informative and helpful for you. In case of any doubt, I will be available for follow ups.
Wish you good health.
Dr Arif
Answered: Tue, 9 Apr 2013
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