Alberico Daniela, Somigliana Edgardo, Bracco Benedetta, Dhouha Dridi, Roberto Anna, Mosconi Paola, Facchin Federica, Vercellini Paolo
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, 20122, Italy.
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan, 20122, Italy; Istituto "Luigi Mangiagalli", Department of Clinical Science and Community Health, University of Milan, Italy.
Eur J Obstet Gynecol Reprod Biol. 2018 Nov;230:182-187. doi: 10.1016/j.ejogrb.2018.08.576. Epub 2018 Aug 22.
To explore the potential benefits of pregnancy on endometriosis symptoms. This is a retrospective study that has been conducted at Academic department and referral center for endometriosis.
We included all conservative women who had a live birth after at least one surgery for endometriosis and who reported pre-pregnancy moderate to severe pelvic pain symptoms (at least one among dysmenorrhea, deep dyspareunia, non menstrual pelvic pain and dyschezia). Data were collected before pregnancy and two years after delivery. The main aim of the study was comparing endometriosis-related pain symptoms before and after pregnancy. Mental health and quality of life were also assessed to investigate the possible psychological benefits of pregnancy.
One-hundred thirty- one women were identified. Forty- nine women (37%, 95% CI: 29-47%) had a clinically relevant recurrence of symptoms requiring medical or surgical treatment. Two years after delivery, 84% of women (95% CI 77-90%) reported at least one moderate-severe pain symptom. A statistically significant improvement was observed for HADS and SF-12 scores but not for FSFI.
Women with endometriosis experiencesymptoms relief during and immediately after pregnancy. However, as for hormonal medical therapy, symptoms rapidly recur in the vast majority of cases.
探讨妊娠对子宫内膜异位症症状的潜在益处。这是一项在子宫内膜异位症学术部门和转诊中心进行的回顾性研究。
我们纳入了所有在至少接受过一次子宫内膜异位症手术后活产的保守治疗女性,这些女性在孕前报告有中度至重度盆腔疼痛症状(痛经、深部性交痛、非经期盆腔疼痛和排便困难中至少有一种)。在怀孕前和分娩后两年收集数据。该研究的主要目的是比较怀孕前后与子宫内膜异位症相关的疼痛症状。还评估了心理健康和生活质量,以调查妊娠可能带来的心理益处。
共确定了131名女性。49名女性(37%,95%置信区间:29 - 47%)出现了需要药物或手术治疗的具有临床意义的症状复发。分娩后两年,84%的女性(95%置信区间77 - 90%)报告至少有一种中度至重度疼痛症状。观察到医院焦虑抑郁量表(HADS)和简明健康调查量表(SF - 12)评分有统计学意义的改善,但性功能指数(FSFI)评分没有改善。
患有子宫内膜异位症的女性在孕期及产后立即会出现症状缓解。然而,与激素药物治疗一样,在绝大多数情况下症状会迅速复发。