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Obstetric Outcome After Surgical Treatment of Endometriosis: A Review of the Literature

A diagnosis of endometriosis is associated with increased risks of adverse pregnancy outcomes including placenta praevia and preterm birth. Some studies have also suggested associations with gestational hypertension, foetal growth restriction, gestational diabetes, perinatal death, and obstetric hae...

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Autores principales: Mooney, Samantha S., Ross, Vanessa, Stern, Catharyn, Rogers, Peter A. W., Healey, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580797/
https://www.ncbi.nlm.nih.gov/pubmed/36303984
http://dx.doi.org/10.3389/frph.2021.750750
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author Mooney, Samantha S.
Ross, Vanessa
Stern, Catharyn
Rogers, Peter A. W.
Healey, Martin
author_facet Mooney, Samantha S.
Ross, Vanessa
Stern, Catharyn
Rogers, Peter A. W.
Healey, Martin
author_sort Mooney, Samantha S.
collection PubMed
description A diagnosis of endometriosis is associated with increased risks of adverse pregnancy outcomes including placenta praevia and preterm birth. Some studies have also suggested associations with gestational hypertension, foetal growth restriction, gestational diabetes, perinatal death, and obstetric haemorrhage. This review aims to assess the impact of pre-pregnancy surgical treatment of endometriosis on future obstetric outcomes. A search of the Medline, Embase and PubMed electronic databases was performed to identify studies reporting pre-pregnancy surgery for endometriosis and subsequent pregnancy outcome compared to controls with unresected endometriosis. Three studies met the inclusion criteria. The studies were heterogenous in design, definition of study groups and outcome measures. All three studies were judged at critical risk of bias. Pre-pregnancy excision of endometriosis was associated with an increased risk of caesarean section in one of two studies, OR 1.72 (95% CI 1.59–1.86) and OR 1.79 (95% CI 0.69–4.64). Placenta praevia rates were also increased in one of two studies OR 2.83 (95% CI 0.56–12.31) and OR 2.04 (95% CI 1.66–2.52). One study found increased risks of preterm birth, small for gestational age, gestational hypertension, and antepartum and postpartum haemorrhage (all p < 0.05) with pre-pregnancy excision of endometriosis. There is insufficient evidence examining the role of pre-pregnancy endometriosis surgery in ameliorating adverse pregnancy outcomes, and thus reliable conclusions cannot be drawn. Prospectively designed studies are needed to assess the relationship between surgical treatments for endometriosis and obstetric outcome and examine potential confounders such as comorbid adenomyosis and infertility.
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spelling pubmed-95807972022-10-26 Obstetric Outcome After Surgical Treatment of Endometriosis: A Review of the Literature Mooney, Samantha S. Ross, Vanessa Stern, Catharyn Rogers, Peter A. W. Healey, Martin Front Reprod Health Reproductive Health A diagnosis of endometriosis is associated with increased risks of adverse pregnancy outcomes including placenta praevia and preterm birth. Some studies have also suggested associations with gestational hypertension, foetal growth restriction, gestational diabetes, perinatal death, and obstetric haemorrhage. This review aims to assess the impact of pre-pregnancy surgical treatment of endometriosis on future obstetric outcomes. A search of the Medline, Embase and PubMed electronic databases was performed to identify studies reporting pre-pregnancy surgery for endometriosis and subsequent pregnancy outcome compared to controls with unresected endometriosis. Three studies met the inclusion criteria. The studies were heterogenous in design, definition of study groups and outcome measures. All three studies were judged at critical risk of bias. Pre-pregnancy excision of endometriosis was associated with an increased risk of caesarean section in one of two studies, OR 1.72 (95% CI 1.59–1.86) and OR 1.79 (95% CI 0.69–4.64). Placenta praevia rates were also increased in one of two studies OR 2.83 (95% CI 0.56–12.31) and OR 2.04 (95% CI 1.66–2.52). One study found increased risks of preterm birth, small for gestational age, gestational hypertension, and antepartum and postpartum haemorrhage (all p < 0.05) with pre-pregnancy excision of endometriosis. There is insufficient evidence examining the role of pre-pregnancy endometriosis surgery in ameliorating adverse pregnancy outcomes, and thus reliable conclusions cannot be drawn. Prospectively designed studies are needed to assess the relationship between surgical treatments for endometriosis and obstetric outcome and examine potential confounders such as comorbid adenomyosis and infertility. Frontiers Media S.A. 2021-12-24 /pmc/articles/PMC9580797/ /pubmed/36303984 http://dx.doi.org/10.3389/frph.2021.750750 Text en Copyright © 2021 Mooney, Ross, Stern, Rogers and Healey. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Reproductive Health
Mooney, Samantha S.
Ross, Vanessa
Stern, Catharyn
Rogers, Peter A. W.
Healey, Martin
Obstetric Outcome After Surgical Treatment of Endometriosis: A Review of the Literature
title Obstetric Outcome After Surgical Treatment of Endometriosis: A Review of the Literature
title_full Obstetric Outcome After Surgical Treatment of Endometriosis: A Review of the Literature
title_fullStr Obstetric Outcome After Surgical Treatment of Endometriosis: A Review of the Literature
title_full_unstemmed Obstetric Outcome After Surgical Treatment of Endometriosis: A Review of the Literature
title_short Obstetric Outcome After Surgical Treatment of Endometriosis: A Review of the Literature
title_sort obstetric outcome after surgical treatment of endometriosis: a review of the literature
topic Reproductive Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9580797/
https://www.ncbi.nlm.nih.gov/pubmed/36303984
http://dx.doi.org/10.3389/frph.2021.750750
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