The effect of the hormonal milieu of pregnancy on deep infiltrating endometriosis: serial ultrasound assessment of changes in size and pattern of deep endometriotic lesions

Maria Elisabetta Coccia, Coccia ME, Francesca Rizzello, Rizzello F, Antonio Palagiano, Palagiano A, Gianfranco Scarselli, Scarselli G
European journal of obstetrics, gynecology, and reproductive biology · 2011 · vol. 160(1) , pp. 35–39 · doi:10.1016/j.ejogrb.2011.10.004 · PMID:22099535 · W2056081406
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This study used serial ultrasound to assess changes in the size and pattern of deep infiltrating endometriosis lesions in response to the hormonal environment of pregnancy.

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Abstract

BackgroundDeep infiltrating endometriosis (DIE) is associated with severe painful symptoms and represents a complex management challenge.ObjectiveTo analyse the effect of pregnancy on deep infiltrating lesions and related symptomatology.Study designAs part of a longitudinal study performed over the past 3 years to determine the efficacy of hormonal treatment in treating women with DIE, we identified three cases of advanced pelvic endometriosis, all with DIE (deep recto-vaginal and recto-sigmoid involvement) where patients achieved spontaneous pregnancies. They were followed up by transvaginal ultrasound (TV-US). The main outcome measures were analysis of the size and echographic pattern of deep infiltrating lesions of endometriosis and evaluation of clinical symptoms during pregnancy.ResultsWe observed modifications in lesion size and pattern. In the two patients observed in the third trimester, the lesions were more homogeneous with less evident limits of nodules and band-like echoes, less fibrotic-like. All patients showed complete resolution of symptoms during pregnancy.ConclusionsThe hormonal environment produced by pregnancy might determine significant modifications of endometriotic lesions and reduce painful symptoms. As surgery for DIE is difficult, complex and can lead to major complications, the achievement of a pregnancy-specific hormonal state, through pregnancy or hormonal treatment, may be a valid option in selected cases.

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Pregnancy Complications Adult Endometriosis Endometriosis Endometriosis Female Humans Longitudinal Studies Pregnancy Pregnancy Complications Pregnancy Complications Pregnancy Complications Ultrasonography

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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.

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