Obstetrical and neonatal outcomes of pregnancies complicated by endometriosis

Shmueli, Anat; Salman, Lina; Hiersch, Liran; Ashwal‏, Eran; Hadar, Eran; Wiznitzer, Arnon; Yogev, Yariv; Aviram, Amir

doi:10.1080/14767058.2017.1393513

Cited by 21 publications

(45 citation statements)

References 15 publications

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“…This discrepancy might have been caused by a difference in sample size, patients’ backgrounds, and study designs. Because our hospital specializes in high-risk pregnancies, in the present study, women in the control group may have higher risks for these complications compared to the control groups of the previous studies [12, 13, 15], indicating that it might have been underpowered to show significant difference in maternal and neonatal outcomes.…”

Section: Discussionmentioning

confidence: 75%

Adverse effects of endometriosis on pregnancy: a case-control study

Miura

Ushida

Imai

et al. 2019

BMC Pregnancy Childbirth

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BackgroundEndometriosis is a common disease occurring in 1–2% of all women of reproductive age. Although there is increasing evidence on the association between endometriosis and adverse perinatal outcomes, little is known about the effect of pre-pregnancy treatments for endometriosis on subsequent perinatal outcomes. Thus, this study aimed to evaluate maternal and neonatal outcomes in pregnant women with endometriosis and to investigate whether pre-pregnancy surgical treatment would affect these outcomes.MethodsThis case-control study included 2769 patients who gave birth at Nagoya University Hospital located in Japan between 2010 and 2017. Maternal and neonatal outcomes were compared between the endometriosis group (n = 80) and the control group (n = 2689). The endometriosis group was further divided into two groups: patients with a history of surgical treatment such as cystectomy for ovarian endometriosis, ablation or excision of endometriotic implants, or adhesiolysis (surgical treatment group, n = 49) and those treated with only medications or without any treatment (non-surgical treatment group, n = 31).ResultsIn the univariate analysis, placenta previa and postpartum hemorrhage were significantly increased in the endometriosis group compared to the control group (12.5% vs. 4.1%, p < 0.01 and 27.5% vs. 18.2%, p = 0.04, respectively). In the multivariate analysis, endometriosis significantly increased the odds ratio (OR) for placenta previa (adjusted OR, 3.19; 95% confidence interval [CI], 1.56–6.50, p < 0.01) but not for postpartum hemorrhage (adjusted OR, 1.14; 95% CI, 0.66–1.98, p = 0.64). Other maternal and neonatal outcomes were similar between the two groups. In patients with endometriosis, patients in the surgical treatment group were significantly associated with an increased risk of placenta previa (OR. 4.62; 95% CI, 2.11–10.10, p < 0.01); however, patients in the non-surgical treatment group were not associated with a high risk (OR, 1.63; 95% CI, 0.19–6.59, p = 0.36). Additionally, other maternal and neonatal outcomes were similar between the two groups.ConclusionWomen who have had surgical treatment for their endometriosis appear to have a higher risk for placenta previa. This may be due to the more severe stage of endometriosis often found in these patients. However, clinicians should be alert to this potential increased risk and manage these patients accordingly.

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Section: Discussionmentioning

confidence: 75%

Adverse effects of endometriosis on pregnancy: a case-control study

Miura

Ushida

Imai

et al. 2019

BMC Pregnancy Childbirth

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“…We identified 14 cohort studies on the association between endometriosis and gestational hypertension [24,[27][28][29]31,33,[46][47][48]50,52,55,57,61], four of which were included in the main-analysis [24,27,28,57] (Figure 3). Endometriosis showed to increase the risk of gestational hypertension with a pooled OR of 1.14 (95% CI: 1.00-1.31).…”

Section: Gestational Hypertensionmentioning

confidence: 99%

“…We identified 21 cohort studies regarding endometriosis and pre-eclampsia [24,[26][27][28][29]31,32,[37][38][39][40][41][42][43]50,52,[54][55][56]61,62]. Ten of these were included in the main metaanalysis [24,27,28,32,[37][38][39][40]56,62] (Figure 4).…”

Section: Pre-eclampsiamentioning

confidence: 99%

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Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis

Breintoft

Pinnerup

Henriksen

et al. 2021

JCM

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Background: This systematic review and meta-analysis summarizes the evidence for the association between endometriosis and adverse pregnancy outcome, including gestational hypertension, pre-eclampsia, low birth weight, and small for gestational age, preterm birth, placenta previa, placental abruption, cesarean section, stillbirth, postpartum hemorrhage, spontaneous hemoperitoneum in pregnancy, and spontaneous bowel perforation in pregnancy. Methods: We performed the literature review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), by searches in PubMed and EMBASE, until 1 November 2020 (PROSPERO ID CRD42020213999). We included peer-reviewed observational cohort studies and case-control studies and scored them according to the Newcastle–Ottawa Scale, to assess the risk of bias and confounding. Results: 39 studies were included. Women with endometriosis had an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth, compared to women without endometriosis. These results remained unchanged in sub-analyses, including studies on spontaneous pregnancies only. Spontaneous hemoperitoneum in pregnancy and bowel perforation seemed to be associated with endometriosis; however, the studies were few and did not meet the inclusion criteria. Conclusions: The literature shows that endometriosis is associated with an increased risk of gestational hypertension, pre-eclampsia, preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth.

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“…Kimutatták továbbá azt is, hogy az endometriosis károsíthatja a junkci- onális zónát, ami a két kórkép kapcsolatát is igazolná [25]. Eredményeink alapján betegeink között gyakrabban fordult elő placenta praevia, amit számos más tanulmány is hasonlóképpen írt le [22,[26][27][28]. Endometriosisban szenvedő nők esetében megváltozik a méh kontrakcióinak frekvenciája és amplitúdója, ami befolyásolhatja az embrió transzportját és beágyazódását [29].…”

Section: Megbeszélésunclassified

A bélendometriosis miatt végzett műtétek hatása a fertilitásra

et al. 2019

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Introduction: Bowel endometriosis is when endometrial-like tissue penetrates the bowel serosa, or it reaches the subserous neurovascular plexus. The effect of surgery for colorectal endometriosis on infertility and pregnancy is not fully proven. Aim: The aim of the present study was to analyse the pregnancy outcome and mode of delivery of patients who underwent ’nerve sparing’ anterior resection of the colon. Method: Between 2009 and 2017, we operated 121 patients with bowel endometriosis, and built up a prospective database where we assessed their wish of pregnancy, the way of the conception, pathologies during pregnancy and mode of delivery. Statistical analysis: The relationship between endometriosis and pregnancy pathologies was tested by a χ2 probe and Fisher’s exact test, additionally the odds ratio (OR) and 95% confidence interval (CI) were determined. For p<0.05, the result was considered significant. Results: Out of 121 bowel endometriosis patients, 48 (39.6%) women got pregnant, 37 (30.5%) of them with in vitro fertilisation. The control group was built from patients who underwent in vitro fertilisation because of andrological factors. We found that women with endometriosis have a significantly higher risk for praeeclampsia (p = 0.023) and placenta praevia (p = 0.045) during pregnancy. Conclusions: Our study is a unique description of pregnancy outcome and mode of delivery after surgery for bowel endometriosis, which, despite the small number of cases, has yielded similar results to the previous multicentric studies. Orv Hetil. 2019; 160(41): 1633–1638.

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Obstetrical and neonatal outcomes of pregnancies complicated by endometriosis

Abstract: Endometriosis is associated with higher risk of cesarean delivery and postpartum hemorrhage. Our findings suggest appropriate preparations for delivery, such as uterotonic agents and blood products, should be considered in these women.

Cited by 21 publications

References 15 publications

Adverse effects of endometriosis on pregnancy: a case-control study

Adverse effects of endometriosis on pregnancy: a case-control study

Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis

A bélendometriosis miatt végzett műtétek hatása a fertilitásra

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