Pathophysiologic mechanisms by which adenomyosis predisposes to postpartum haemorrhage and other obstetric complications

Simona Martone, Martone S, Gabriele Centini, Exacoustos C, C. Exacoustós, Caterina Exacoustos, Errico Zupi, Zupi E, Afors K, Karolina Afors, Fabrizio Zullo, Maneschi F, Francesco Maneschi, Habib N, Nassir Habib, Lucia Lazzeri
Medical hypotheses · 2020 · vol. 143 , pp. 109833 · doi:10.1016/j.mehy.2020.109833 · PMID:32498005 · W3024972854
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This paper investigated the pathophysiologic mechanisms linking adenomyosis to postpartum hemorrhage and other obstetric complications.

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Abstract

Adenomyosis is characterized by the presence of ectopic endometrium within the myometrium. This features lead to structural changes in the surrounding myometrium and endometrium resulting also in functional changes. Alterations in the myometrium are suspected to lead to defective remodeling of spiral arteries during the early stages of decidualization resulting in altered vascular resistance and defective placentation. These alterations could play a common part in the association between adenomyosis and major obstetric complications. Latest epidemiological studies show that adenomyosis is associated with preterm birth, preeclampsia, IUGR and increased caesarean section rates, but very little is known of any underlying mechanism linking postpartum hemorrhage and adenomyosis. It is our opinion that adenomyosis may increase the risk of postpartum hemorrhage through several mechanisms that will be further clarified. Women with adenomyosis may require specific management during pregnancy and may benefit from wider understanding of the pathological mechanisms associated with this disease process.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Postpartum Hemorrhage Postpartum Hemorrhage Premature Birth Cesarean Section Endometrium Female Humans Infant, Newborn Myometrium Pregnancy

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (52)

Cited by (10)

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