Department of Biomedicine and Prevention Obstetrics and Gynecological Clinic, University of Rome "Tor Vergata," Rome, Italy.
Department of Obstetrics and Gynecology, University of Parma, Parma, Italy.
Fertil Steril. 2016 Oct;106(5):1129-1135.e1. doi: 10.1016/j.fertnstert.2016.06.024. Epub 2016 Jul 18.
To study outcomes and complications during pregnancy and at delivery in women with a posterior deep infiltrating endometriosis (DIE) nodule persisting after surgery and diagnosed at transvaginal sonography (TVS) in comparison with a control group of women without endometriosis.
Multicenter observational and cohort study.
University hospital.
PATIENT(S): Women (n = 200) with a posterior DIE nodule equal or more than 2 cm centimeters in size who desired a pregnancy and a control group of women (n = 300) with no previous recorded diagnosis of endometriosis who delivered in our clinic during the same time period.
INTERVENTION(S): Patient data collected from medical charts and by phone interviews.
MAIN OUTCOME MEASURE(S): Evaluation of complications during pregnancy and delivery.
RESULT(S): Of the 101 women with a posterior DIE nodule, 52 become pregnant among whom 25 used assisted reproductive technology. Of these 52 pregnancies, 11 ended in an early abortion, and 41 delivered a baby; 13 (31.7%) had a premature delivery, 7 (17.8%) a placenta praevia, and 28 (68.2%) had a cesarean delivery. When compared with the control group, the women with endometriosis had a higher risk of pregnancy complicated by preterm birth, placenta previa, placental abruption, and hypertension. Cesarean delivery and complications during surgery (hysterectomy, hemoperitoneum, and bladder injuries) were statistically significantly more frequent in women with endometriosis than in controls.
CONCLUSION(S): Women with an incomplete removal of posterior DIE have a high complications rate during pregnancy and delivery.
研究经阴道超声（TVS）诊断为术后持续性后深部浸润型子宫内膜异位症（DIE）结节的患者在妊娠和分娩期间的结局和并发症，并与无内异症的对照组患者进行比较。
多中心观察性队列研究。
大学医院。
200 名患有大小等于或大于 2 厘米的后深部浸润型 DIE 结节并希望妊娠的患者和同期在我院分娩的 300 名无既往内异症记录诊断的对照组患者。
从病历和电话访谈中收集患者数据。
评估妊娠和分娩期间的并发症。
在 101 名患有后深部浸润型 DIE 结节的患者中，有 52 名怀孕，其中 25 名使用了辅助生殖技术。在这 52 例妊娠中，11 例早期流产，41 例分娩；13 例（31.7%）早产，7 例（17.8%）前置胎盘，28 例（68.2%）剖宫产。与对照组相比，患有内异症的患者妊娠早产、前置胎盘、胎盘早剥和高血压的风险更高。与对照组相比，患有内异症的患者剖宫产和手术期间并发症（子宫切除术、血腹和膀胱损伤）的发生率更高，具有统计学意义。
深部浸润型 DIE 切除不完全的患者在妊娠和分娩期间并发症发生率较高。
