Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan 11;13(2):414.
doi: 10.3390/jcm13020414.

Women with Endometriosis-Who Is at Risk for Complications Associated with Pregnancy and Childbirth? A Retrospective Case-Control Study

Teresa Mira Gruber  1 , Laura Ortlieb  1 , Wolfgang Henrich  1 , Sylvia Mechsner  2
Affiliations

Women with Endometriosis-Who Is at Risk for Complications Associated with Pregnancy and Childbirth? A Retrospective Case-Control Study

Teresa Mira Gruber et al. J Clin Med. .

Abstract

Women with endometriosis (EM), particularly the manifestations of adenomyosis (AM) and deep infiltrating endometriosis (DIE), suffer from pain and sterility. DIE also appears with several specific obstetric complications. To determine the risk profile, we designed a retrospective case-control study. Primary outcomes were defined as the risk of preterm birth and caesarean delivery (CD). Primiparous singleton pregnancies in women with DIE were compared with controls without EM. We matched for mode of conception and maternal age. A total of 41 women diagnosed with DIE and 164 controls were recruited. A total of 92.7% of the cases were also diagnosed with AM. Preterm birth occurred in 12.2% of cases and in 6.7% of controls. The difference was not statistically significant (OR: 1.932; 95% CI: 0.632-5.907). The rate of CD was similar in both groups. Remarkably, placental implantation disorders in the form of placenta praevia were eight times more frequent in women with DIE (9.8%) than in controls (1.2%, OR: 8.757; 95% CI: 1.545-49.614). Neonatal outcome was similar in both groups. Four out of fourteen cases reported abdominal wall endometriosis after CD. Women with DIE/AM and with placenta praevia are at risk of bleeding complications. After CD, they can develop abdominal wall EM. We therefore suggest evaluating the birth mode in each woman with DIE/AM.

Keywords: adenomyosis; caesarean delivery; deep infiltrating endometriosis; endometriosis; placenta praevia; pregnancy outcome; preterm delivery.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow chart of recruitment of cases. DIE: deep infiltrating endometriosis.
Figure 2
Figure 2
Selection of controls. IVF/ICSI: in vitro fertilisation/intracytoplasmatic sperm injection.
See this image and copyright information in PMC

References

    1. Gruber T.M., Mechsner S. Pathogenesis of Endometriosis: The Origin of Pain and Subfertility. Cells. 2021;10:1381. doi: 10.3390/cells10061381. - DOI - PMC - PubMed
    1. De Ziegler D., Borghese B., Chapron C. Endometriosis and infertility: Pathophysiology and management. Lancet. 2010;376:730–738. doi: 10.1016/S0140-6736(10)60490-4. - DOI - PubMed
    1. Ferrero S., Esposito F., Abbamonte L.H., Anserini P., Remorgida V., Ragni N. Quality of sex life in women with endometriosis and deep dyspareunia. Fertil. Steril. 2005;83:573–579. doi: 10.1016/j.fertnstert.2004.07.973. - DOI - PubMed
    1. Zullo F., Spagnolo E., Saccone G., Acunzo M., Xodo S., Ceccaroni M., Berghella V. Endometriosis and obstetrics complications: A systematic review and meta-analysis. Fertil. Steril. 2017;108:667–672.e5. doi: 10.1016/j.fertnstert.2017.07.019. - DOI - PubMed
    1. Menzlova E., Zahumensky J., Gürlich R., Kucera E. Rectal injury following delivery as a possible consequence of endometriosis of the rectovaginal septum. Int. J. Gynaecol. Obstet. 2014;124:85–86. doi: 10.1016/j.ijgo.2013.06.038. - DOI - PubMed

LinkOut - more resources