Abstract
Background and objective: Previous studies did not draw a definitive conclusion about the influence of the role of deep endometriosis (DE) and ovarian endometrioma (OE) as risk factor for developing adverse perinatal outcomes in patients affected by endometriosis. This study aimed to investigate if adverse fetal and maternal outcomes, and in particular the incidence of small for gestational age (SGA) infants, are different in pregnant women with OE versus pregnant women with DE without OE. Material and methods: This study was based on a retrospective analysis of a database collected prospectively. The population included in the study was divided into three groups: patients with OE, patients with DE without concomitant OE, and patients without endometriosis (controls). The controls were matched on the basis of age and parity. Demographic data at baseline and pregnancy outcomes were recorded. Results: There was no statistically significant difference in first trimester levels of PAPP-A, first and mid-pregnancy trimester mean Uterine Artery Doppler pulsatile index, estimated fetal weight centile, and SGA fetuses’ prevalence for patients with OE, and those with DE without OE in comparison to health women; moreover, there was no statistically significant difference with regard to SGA birth prevalence, prevalence of preeclampsia, and five-minute Apgar score between these three groups. Conclusions: The specific presence of OE or DE in pregnant women does not seem to be associated with an increased risk of delivering an SGA infant. These data seem to suggest that patients with endometriosis should be treated in pregnancy as the general population, thus not needing a closer monitoring.
Highlights
Endometriosis is a chronic estrogen-dependent gynecologic disorder affecting at least 3.6% of women of reproductive age [1]
Standardized ultrasonographic criteria were employed for the diagnosis of deep endometriosis (DE) [19] and ovarian endometrioma (OE) [20]; in particular, women with rectosigmoid endometriosis underwent a detailed assessment of intestinal symptoms and a rectal water contrast transvaginal ultrasonography in order to estimate the risk of sub occlusion prior to trying to spontaneously conceive [21,22]
The results obtained from this study demonstrate that the presence of OE or DE in pregnant women is not associated with an increased risk of delivering small for gestational age (SGA) infants
Summary
Endometriosis is a chronic estrogen-dependent gynecologic disorder affecting at least 3.6% of women of reproductive age [1]. Medicina 2019, 55, 550 progesterone, and to alteration of oxidative stress response, presence of inflammatory mediators, cytokines, and various apoptotic markers [3,4,5] Due to these abnormalities, endometriosis has been associated with defective deep placentation and several obstetrics adverse outcomes [6]. Conclusions: The specific presence of OE or DE in pregnant women does not seem to be associated with an increased risk of delivering an SGA infant. These data seem to suggest that patients with endometriosis should be treated in pregnancy as the general population, not needing a closer monitoring
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