Impact of endometriosis on pregnancy

Oana Bodean, Delia Grădinaru-Fometescu, Alina Potorac, Diana C. Secară, Monica Mihaela Cîrstoiu
In: Obstetrica şi Ginecologia · 2022 · vol. 3(70) , pp. 106 · doi:10.26416/obsgin.70.3.2022.7204 · W4312478695
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

This review examines the impact of pre-existing endometriosis on pregnancy, highlighting challenges in diagnosis and treatment and emphasizing the risk of adverse maternal and fetal outcomes.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This paper is a narrative review of published evidence (PubMed search through August 2022) on adverse pregnancy outcomes in women with preexisting endometriosis and related conditions, focusing on miscarriage, spontaneous preterm birth, obstetric hemorrhage, preeclampsia, and small for gestational age, and also describing examples from pregnancies admitted to a Romanian emergency hospital. It highlights that pregnancy-induced hormonal changes can alter endometriotic lesion appearance, complicating diagnosis, and it summarizes associations reported in the literature for outcomes such as ectopic pregnancy, increased miscarriage risk (including data implicating adenomyosis), and higher rates of preterm-related complications, while noting that conclusions are limited by heterogeneity and confounding (e.g., ART and infertility causes). The review also covers rare but serious complications during pregnancy related to deep endometriosis, including bowel perforation, spontaneous hemoperitoneum, uterine rupture, and urinary tract/peritoneal complications, and discusses imaging considerations for decidualized ovarian endometriomas, with biomarkers not recommended. This paper is centrally about endometriosis — it specifically reviews how endometriosis and adenomyosis affect pregnancy outcomes and complications.

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Abstract

Endometriosis and adenomyosis are pathologies that frequently affect women of reproductive age. For these women, obtaining a pregnancy is often difficult, some patients being advised to use assisted reproductive techniques. The ectopic endometrial-like tissue situated outside the uterine cavity responds to pregnancy-induced hormonal changes. This alters the appearance of the endometrial lesions. Therefore, the diagnosis and treatment of endometriosis in pregnant women are a real challenge. Endometriosis and adenomyosis preexistent to pregnancy have various effects on the mother and fetus, being a novel research subject in the recent years. The 2022 ESHRE Guidelines for endometriosis strongly recommend clinicians to be aware of adverse pregnancy outcomes, especially during the first trimester, in pregnancies associated with preexisting endometriosis. It is better to diagnose and treat endometriosis prior to obtaining a pregnancy, because pregnancy itself does not always improve endometriosis, as it was previously stated, and the patients often need a multidisciplinary approach. Although there are no specific follow-up protocols for pregnancies with preexisting endometriosis, specialists and their patients must be aware of the unfavorable outcomes. Our article is a review of the latest literature about the impact of endometriosis on pregnancy. We also present some examples of endometriosis that we encountered in patients admitted to our hospital.

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endometriosisadenomyosis

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last seen: 2026-06-10T17:14:06.276822+00:00
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