Hospital da Luz, Lisbon, Portugal.
Hospital São Francisco Xavier-CHLO, Portugal.
Fertil Steril. 2014 Feb;101(2):442-6. doi: 10.1016/j.fertnstert.2013.11.001. Epub 2013 Dec 18.
To review bowel complications caused by deep endometriosis during pregnancy or in vitro fertilization (IVF).
Three case reports and a systematic review.
A tertiary referral center for deep endometriosis surgery.
PATIENT(S): Three case reports of bowel perforation or occlusion during pregnancy caused by deep endometriosis.
INTERVENTION(S): A PubMed search was conducted to identify complications of deep endometriosis during pregnancy or IVF. The literature search identified 13 articles. According to these, 12 articles described 12 bowel complications caused by progression of deep endometriosis during pregnancy, and 1 article described six cases of bowel occlusion during IVF.
RESULT(S): In 12 of 15 women, complications occurred during the third trimester of pregnancy, whereas 3 of 15 women presented with complications in the postpartum period. All complications during IVF occurred during stimulation. No specific factors that could predict these complications were identified, leading to the conclusion that endometriosis complications that occur in pregnancy or in IVF patients are probably underreported.
CONCLUSION(S): Bowel complications during pregnancy or IVF stimulation may occur in women with deep endometriosis. This suggests that the endocrine environment of pregnancy does not prevent progression, at least in some women. These complications are rare, although probably underreported.
回顾妊娠或体外受精（IVF）期间深部子宫内膜异位症引起的肠道并发症。
3 例病例报告和系统评价。
深部子宫内膜异位症手术的三级转诊中心。
3 例妊娠期间因深部子宫内膜异位症导致肠穿孔或闭塞的病例报告。
对 PubMed 进行了搜索，以确定妊娠或 IVF 期间深部子宫内膜异位症的并发症。文献检索确定了 13 篇文章。根据这些文章，12 篇文章描述了 12 例妊娠期间深部子宫内膜异位症进展引起的肠道并发症，1 篇文章描述了 6 例 IVF 期间肠道闭塞的病例。
在 15 名女性中，有 12 名在妊娠的第三个三个月出现并发症，而 15 名中有 3 名在产后出现并发症。所有在 IVF 期间发生的并发症都发生在刺激期间。没有发现可以预测这些并发症的特定因素，这表明妊娠或 IVF 患者中发生的子宫内膜异位症并发症可能被低估了。
妊娠或 IVF 刺激期间可能会发生深部子宫内膜异位症的肠道并发症。这表明妊娠的内分泌环境并不能阻止至少某些女性的疾病进展。这些并发症虽然罕见，但可能被低估了。
