Endometriosis and Perinatal Outcome - A Systematic Review of the Literature

Current Women’s Health Reviews, 04/23/2012

Symptoms of endometriosis often disappear during pregnancy. Yet, endometriosis must be included in the differential diagnosis of hemoperitoneum presenting during pregnancy or of heavy vaginal bleeding postpartum. Both maternal and fetal morbidity and mortality can be quite high and the woman's childbearing ability might be irreversibly affected.

Methods

  • Authors searched all publications in Pubmed, Scopus and the Cochrane Library with the key words endometriosis, pregnancy outcome, preeclampsia, preterm birth, small–for gestational age babies (SGA) and postpartum.
  • All studies reporting on endometriosis and perinatal outcome until December 2009.

Results

  • According to the available bibliographic data, they found 38 reported cases of pregnancies, four being twin pregnancies, complicated by endometriosis.
  • Studies referring to specific pregnancy complications (preterm birth, small–for–gestational age babies, preeclampsia and postpartum complications) were limited to a total of 12 publications.
  • Data regarding the effect of endometriosis on preterm birth, small–for gestational age babies and preeclampsia, both in spontaneous pregnancies as well as in those conceived by Assisted Reproductive Techniques (ART) were conflicting.
  • The few reported complications during pregnancy included hemoperitoneum and spontaneous bleeding , perforations of the jejunum, appendix and sigmoid colon, urohemoperitoneum , deciduosis of the appendix , deciduosis of the omentum, infected endometrioma, hemoperitoneum and hemothorax, catamenial pneumothorax, endometriosis imitating a bladder tumor, decidualization mimicking ovarian malignancy, rupture of ovarian endometriotic cyst, and rupture of the uterus affected by endometriosis.

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