TY - JOUR
T1 - Pregnancy outcomes in women with history of surgery for endometriosis
AU - Farella, Marilena
AU - Chanavaz-Lacheray, Isabella
AU - Verspick, Eric
AU - Merlot, Benjamin
AU - Klapczynski, Clemence
AU - Hennetier, Clotilde
AU - Tuech, Jean Jacques
AU - Roman, Horace
PY - 2020/5
Y1 - 2020/5
N2 - 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.
AB - 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.
KW - Endometriosis
KW - placenta previa
KW - pregnancy
KW - preterm birth
KW - small for gestational age
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U2 - 10.1016/j.fertnstert.2019.12.037
DO - 10.1016/j.fertnstert.2019.12.037
M3 - Article
AN - SCOPUS:85083329208
VL - 113
SP - 996
EP - 1004
JO - Fertility and Sterility
JF - Fertility and Sterility
SN - 0015-0282
IS - 5
ER -