P28.13: Pregnancy outcomes associated with presence and severity of adenomyosis

The comparison of pregnancy outcomes between pregnant women with adenomyosis and without adenomyosis. The second comparison of pregnancy outcomes within the adenomyosis group according to the characteristics and severity of lesions. Data from the women who delivered singleton babies in Korea University Ansan Hospital, from 2005 to 2015 was retrospectively reviewed. Patients with chronic hypertension, overt DM or other general medical problems were excluded. Regardless of gestational age, sonographic recordings were done upon the patients' arrival of the medical centre. Diagnoses were made with these initial sonographic findings or made with a pathologic confirmation after Caesarean hysterectomy. 46 cases were included in the adenomyosis without previous treatment group. Among the others, randomly selected 102 cases were included in the control group. The comparison was initially performed between the adenomyosis group and the control group. There were significant differences in gestational age (P = 0.020), neonatal birthweight (P = 0.026), placenta previa (P = 0.008), and pre-eclampsia (P < 0.001) where the patients in the adenomyosis group presented adverse outcomes. There were no significant differences in gestational hypertension, PROM, preterm birth, and abnormal fetal presentation. The second comparison within the adenomyosis group revealed no significant differences according to the lesion depth, diffuse or focal lesions, relationships between the lesion and placenta, or gray scale on 2D sonography. The results coincide with the recent findings that adenomyosis affects pregnancy outcomes in pregnant women. Although the rate of preterm births did not increase, patients with adenomyosis did show a significant decrease in gestational age and neonatal birth weight. The study shows that adenomyosis also may affect placental implantation as well as abnormal trophoblastic invasion, which is supported by the increase in preeclampsia cases. However, this study failed to find any useful criteria on the characteristics of adenomyosis affecting clinical outcomes.