Endometriosis and Recurrent Pregnancy Loss as New Risk Factors for Venous Thromboembolism during Pregnancy and Post-Partum: The JECS Birth Cohort

Sugiura‐Ogasawara, Mayumi; Ebara, Takeshi; Matsuki, Taro; Yamada, Yasuyuki; Omori, Toyonori; Matsumoto, Yosuke; Kato, Sayaka; Kano, Hirohisa; Kurihara, Takahiro; Saitoh, Shinji; Kamijima, Michihiro

doi:10.1055/s-0039-1677733

Cited by 25 publications

(16 citation statements)

References 25 publications

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“…The relative risk of combined coronary heart disease events was 1.62 (95% confidence interval: 1.39-1.89) after adjustment for confounders [46,47]. Moreover, endometriosis has been interestingly identified as a novel predicting factor for venous thromboembolism during pregnancy and postpartum in a Japanese birth cohort study [48]. Factors contributing to this increased risk have not been deeply investigated.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Coagulation Parameters in Women Affected by Endometriosis: Validation Study and Systematic Review of the Literature

et al. 2020

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The presence of endometriosis determines an inflammatory response locally. The objective of this validation study and systematic review was to assess systemic levels of coagulation and inflammatory parameters in women with or without the disease. We conducted a retrospective analysis of a database prospectively collected from January 2017 to February 2020 including n = 572 women who underwent laparoscopic surgery for endometriosis (cases, n = 324) or other benign gynecologic diseases (controls, n = 248). Inflammatory markers and coagulation parameters were determined. An advanced systematic search of the literature on the same parameters was conducted up to April 2020. A significantly higher neutrophil count was found in endometriosis patients. Patients with endometriomas and stage III–IV disease had a significantly lower absolute lymphocyte count and shortened activated partial thromboplastin time (aPTT) values. In the final regression model, aPTT retained significant predictive value for stage III–IV endometriosis (odds ratio (OR) = 0.002, 95% confidence interval (CI) = 0.00–0.445; p = 0.024). Results from the n = 14 included studies in the systematic review are characterized by a high variability, but some consistency has been found for alterations in thrombin time, platelet-to-lymphocyte ratio, and neutrophil count associated with endometriosis. Modest systemic changes of some inflammatory and coagulation parameters are associated with endometriosis. Indeed, all the modifications detected are still within the normal reference intervals, explaining the high heterogeneity among studies.

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Section: Discussionmentioning

confidence: 99%

Assessment of Coagulation Parameters in Women Affected by Endometriosis: Validation Study and Systematic Review of the Literature

et al. 2020

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“…Actual obstetric complications encountered in cases of endometriosis. The risk of obstetric complications in cases of endometriosis was reported widely recently (78)(79)(80)(81), although some studies fail to find such links (9,(82)(83)(84)(85). Also, the incidence of endometriosis may be associated with genetic or lifestyle factors, which are likewise associated with a higher pregnancy loss (e.g., smoking) (12, 13, 86, 87).…”

Section: Endometriosis and Early Pregnancy Losses: What Is The Evidence?mentioning

confidence: 99%

Endometrial causes of recurrent pregnancy losses: endometriosis, adenomyosis, and chronic endometritis

Pirtea

Cicinelli

Nola

et al. 2021

Fertility and Sterility

107

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Chronic inflammatory processes affecting the endometrium, as encountered in endometriosis, adenomyosis, and chronic endometritis, alter endometrial receptivity. These disorders are associated with early pregnancy losses and possibly recurrent pregnancy losses (RPL). In the cases of endometriosis, other factors associated with the disease also are susceptible of causing miscarriages and possibly RPL, such as an impact of intrapelvic inflammatory processes affecting the oocyte and embryo in case of natural conception. Conversely these latter effects obviously are bypassed in case of assisted reproductive technology. Chronic inflammation of the endometrium in the condition known as chronic endometritis also causes early pregnancy losses and RPL with beneficial effects achieved when specific treatment is undertaken. (Fertil Steril Ò 2021;115:546-60. Ó2020 by American Society for Reproductive Medicine.

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“…Відношення шансів тромбоемболій для жінок з ендометріозом становило 2,70 (95% ДІ: 1,21-6,00), а для пацієнток зі звичним невиношуванням -6,13 (95% ДІ: 2,48-15,16). Даний контингент потребує ретельного моніторингу системи гемостазу під час вагітності, пологів та у період пуерперію [18].…”

Section: д и с т а н ц і й н е н а в ч а н н яunclassified

The peculiarities of the management of women with endometriosis during pregnancy

Лахно

2021

RHW

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Endometriosis is a significant problem in modern medicine. The prevalence of endometriosis is 10%, it occurs in 38% of women with infertility. For a century, it was believed that pregnancy contributes to the reduction in volume and even the disappearance of foci of endometriosis. Also, the state of «pseudopregnancy» under the influence of combined oral contraceptives was once considered an effective treatment strategy. To date, it is known that decidualization of endometrioid heterotopias not only contributes to their increase in size, but can also provoke bleeding. These changes can mimic ovarian cancer on ultrasonography. Typical complications of endometriosis are enlargement, rupture, or abscess formation.It has been proven that women with endometriosis have an increased relative risk of developing: preeclampsia by 19%; fetal growth retardation by 12%; premature birth by 46%; placenta previa almost threefold; preterm placental abruption by 40%; caesarean section operations by 49%; stillbirth by 27%; postpartum hemorrhage by 5%; spontaneous intra-abdominal bleeding by 24.6 times – only two cases are known in women with endometriosis and no bleeding from the intact peritoneum is known; spontaneous bowel perforation (only 18 cases are known). It has been proven that in pregnant women with endometriosis, the invasion of the extravillous trophoblast into the spiral vessels of the uterus is impaired. However, there is evidence that the endometrioid phenotype is not associated with placental dysfunction and does not increase the risk of developing great obstetric syndromes.Since most of the complications of endometriosis during pregnancy cannot be predicted, any additional interventions are not of use. So, to date, there is no evidence of the need to introduce separate protocols for the management of women with endometriosis during pregnancy. However, there should be an individualization of the approach in each separate case. The given atypical clinical case in a woman with diffuse adenomyosis demonstrates the importance of the problem of predicting various complications of pregnancy and childbirth. Moreover, clinical cases contribute to the continuation of the study of this disease.

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Endometriosis and Recurrent Pregnancy Loss as New Risk Factors for Venous Thromboembolism during Pregnancy and Post-Partum: The JECS Birth Cohort

Cited by 25 publications

References 25 publications

Assessment of Coagulation Parameters in Women Affected by Endometriosis: Validation Study and Systematic Review of the Literature

Assessment of Coagulation Parameters in Women Affected by Endometriosis: Validation Study and Systematic Review of the Literature

Endometrial causes of recurrent pregnancy losses: endometriosis, adenomyosis, and chronic endometritis

The peculiarities of the management of women with endometriosis during pregnancy

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