Monday 15 June 2015

Endometriosis and Pregnancy

Endometriosis is a very common finding in infertility investigations, however, not much is known about endometriosis and pregnancy. A large recent study in UK found that endometriosis is related to a higher incidence of miscarriages and ectopic pregnancies in the early stages of pregnancy. It found higher rates of placental haemorrhage and preterm labour. This study would suggest that it may be wise to consider surgery or treatment of endometriosis prior to getting pregnant. It was always considered okay to allow a woman who has minimal endometriosis to try for a pregnancy and the usual message to the patient would be that if she does get pregnant, the endometriosis would get better, and she would not need further treament. This study showed that endometriosis has a great impact on the pregnancy which needs to be considered in counselling patients who are trying to get pregnant with endometriosis. It is also my experience that the endometriosis does not get better after the pregnancy and will continue to get worse in time. During caesarean section deliveries of pregnant women who had undiagnosed endometriosis are found to have florid bleeding of endometriotic deposits on the womb and ovaries, again indicating that the endometriosis does not go away with pregnancy, and will probably need to be treated at some later time.

The take home message is that all women planning to get pregnant should have a thorough gynaecological examination to exclude endometriosis, especially since endometriosis is affecting younger and younger women today.

http://www.sciencedaily.com/releases/2015/06/150614225739.htm