Main Article Content
An Audit of Diagnosis and Management of Polycystic Ovarian Syndrome
Abstract
Background: Despite rapidly evolving information associated with polycystic ovarian syndrome (PCOS) in recent times, there has been scanty documentation of experience with this gynaecological condition in our environment and the challenges associated with diagnosing and managing this condition in a resource poor setting like ours.
Methodology: A retrospective study of all cases of polycystic ovarian syndrome managed in the gynaecological clinic in JUTH over a 5-year period was carried out.
Results: During the study period there were 17 cases of polycystic ovarian syndrome giving a prevalence rate of 0.55% (1/182) of all gynaecological cases within the reproductive age group. Only 13 out of the 17 folders of these patients could be retrieved (76.47%). The age of these patients ranged between 19 and 42years (mean 26.4 ±5 years). Of these, 85% were nullipara. The patients presented with infertility (92.3%), oligomenorrhoea/ ammenorrhoea (77%), obesity (15.4%), hirsuitism(15.4%), recurrent pregnancy losses(7.7%) and galactorrhoea (7.7%). Ultrasound scan revealed polycystic ovaries in 84.6% of these patients. Only 30.8% of these patients had hormonal profile done which all revealed increased LH/FSH ratio and 7.7% had increased prolactin. Fasting blood sugar was available for only 23.1% of these patients and these were normal. Nine patients met the Rotterdam's criteria for the diagnosis of PCOS. Treatment was commenced for 53.8% of the patients with pregnancy achieved in 15.4%. However, 69.2% of patients were lost to follow up.
Conclusion: PCOS needs to have acceptable and locally applicable standardized diagnostic criteria. Investigations should be made available and affordable and the problem of patient follow-up needs to be addressed.
Methodology: A retrospective study of all cases of polycystic ovarian syndrome managed in the gynaecological clinic in JUTH over a 5-year period was carried out.
Results: During the study period there were 17 cases of polycystic ovarian syndrome giving a prevalence rate of 0.55% (1/182) of all gynaecological cases within the reproductive age group. Only 13 out of the 17 folders of these patients could be retrieved (76.47%). The age of these patients ranged between 19 and 42years (mean 26.4 ±5 years). Of these, 85% were nullipara. The patients presented with infertility (92.3%), oligomenorrhoea/ ammenorrhoea (77%), obesity (15.4%), hirsuitism(15.4%), recurrent pregnancy losses(7.7%) and galactorrhoea (7.7%). Ultrasound scan revealed polycystic ovaries in 84.6% of these patients. Only 30.8% of these patients had hormonal profile done which all revealed increased LH/FSH ratio and 7.7% had increased prolactin. Fasting blood sugar was available for only 23.1% of these patients and these were normal. Nine patients met the Rotterdam's criteria for the diagnosis of PCOS. Treatment was commenced for 53.8% of the patients with pregnancy achieved in 15.4%. However, 69.2% of patients were lost to follow up.
Conclusion: PCOS needs to have acceptable and locally applicable standardized diagnostic criteria. Investigations should be made available and affordable and the problem of patient follow-up needs to be addressed.
