Risks of adverse pregnancy outcome in endometriosis

Capsule:
Endometriosis increases the risk of several pregnancy complications; some are caused by ectopic lesions, whereas others may reflect the impact of an adverse uterine environment on placenta formation.

Authors:
Ivo Brosens, M.D., Ph.D., Jan J. Brosens, M.D., Ph.D., Luca Fusi, M.D., Marwa Al-Sabbagh, Ph.D., Keiji Kuroda, M.D., Ph.D., Giuseppe Benagiano, M.D., Ph.D.
Volume 98, Issue 1 , Pages 30-35, July 2012

Abstract:
Bleeding from endometriotic implants is now an established cause of acute hemoperitoneum in pregnancy. However, the adverse impact of pelvic endometriosis on uterine function before conception may also interfere with subsequent deep placentation, accounting for the increased risk of obstetrical complications, including preterm birth and antepartum hemorrhage.

  • Ivo Brosens

    What is new? Studies on uterine disorders such as endometriosis, adenomyosis or congenital uterine anomalies frequently report on infertility, miscarriage and births, but not on the major obstetrical outcomes such as preterm births and SGA although they create higher health problem than infertility or miscarriages. The current review shows the current evidence that changes in the junctional zone can create vascular resistance during the process of deep placentation. Defective transformation of the myometrial spiral arteries resulting in vascular resistance has been demonstrated to be present in major obstetrical disorders such as late abortion, preterm birth, SGA and preeclampsia. New is the link between common uterine disorders and, in case of pregnancy, the risk of major obstetrical complications.

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