Pregnancy outcomes in women with history of surgery for endometriosis

The risk of small for gestational age babies and preterm delivery is increased in women with a history of surgery for endometriosis, although conception with the use of ART may affect outcomes.

Like Comment
Related Content

Volume 113, Issue 5, Pages 996–1004

Authors:

Marilena Farella, M.D., Isabella Chanavaz-Lacheray, M.D., Eric Verspick, M.D., Ph.D., Benjamin Merlot, M.D., Clemence Klapczynski, M.D., Clotilde Hennetier, M.D., Jean-Jacques Tuech, M.D., Ph.D., Horace Roman, M.D., Ph.D.

Abstract:

Objective

To assess the relationship between history of surgery for endometriosis and adverse obstetrical outcomes.

Design

Retrospective study using prospectively recorded data.

Setting

Referral center.

Patient(s)

Total of 569 women with history of surgery for endometriosis, postoperative conception, and pregnancy evolution over 22 weeks of gestation.

Interventions(s)

Surgery for endometriosis.

Main Outcome Measure(s)

Small for gestational age (SGA) status of the newborn, spontaneous preterm birth (PT, before 37 weeks’ gestation), and placenta previa.

Results

Among 733 pregnancies included in the study, 566 deliveries were recorded (77.2%), of which 535 were singleton (72.9% of pregnancies) and 31 twins (4.2%). SGA was observed in 81 of 535 (15.1%) singleton pregnancies and in 9 of 31 (29%) twin pregnancies. PT occurred in 53 of 535 (9.9%) singleton pregnancies and in 19 of 31 (61.2%) twin pregnancies. The number of singleton and multiple pregnancies complicated by placenta previa were, respectively, 9 of 535 (1.7%) and 0 of 31. The independent factor found to relate to SGA was the absence of endometriomas; conception with the use of assisted reproductive technologies (ART) only tended toward statistical significance. Independent factors found to increase risk of PT were conception with the use of ART, body mass index >30 kg/m2, and surgery of deep endometriosis infiltrating the rectum and the bladder. Independent factors associated with placenta previa were conception with the use of ART and history of stage III or IV endometriosis.

Conclusion(s)

The risk of SGA and PT is increased in women with a history of surgery for endometriosis, and a high rate of conception with the use of ART may jeopardize outcomes.



Read the full text here.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

No comments yet.