Vaginal parturition decreases recurrence of endometriosis

Bulletti C, Carlo Bulletti, Anna Montini, Paolo Emanuele Levi-Setti, Paolo Levi Setti, Setti PL, Antonio Palagiano, Palagiano A, Ubaldi F, Filippo Maria Ubaldi, Filippo Ubaldi, Borini A, Andrea Borini
Fertility and sterility · 2009 · vol. 94(3) , pp. 850–855 · doi:10.1016/j.fertnstert.2009.04.012 · PMID:19524893 · W2106561757
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This study investigated the impact of vaginal birth on endometriosis recurrence, finding that it decreases the likelihood of the condition returning.

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Abstract

ObjectiveTo evaluate the role of parturition in the recurrence of endometriosis.DesignRetrospectively analyzed, prospectively obtained data.SettingUnit of Physiopathology of Reproduction, Health Care Unit of Rimini, and University of Bologna Cervesi General Hospital, Cattolica, Italy.Patient(s)Three hundred forty-five patients with stage II-IV endometriosis, dysmenorrhea, and infertility were treated for endometriosis and divided into four groups according to parity and mode of parturition.Intervention(s)The patients were laparoscopically treated for endometriosis upon the occurrence and recurrence of the disease. Ultrasound measurements of the uterine internal ostium (IOS) were performed at each study interval.Main outcome measure(s)Degree of dysmenorrhea, occurrence and recurrence of endometriosis, and uterine IOS measurements were established and related to parity and mode of parturition.Result(s)After parturition, dysmenorrhea recurrence was significantly higher in nulliparous women than in women with vaginal parturition. The endometriosis recurrence rate was higher in women who did not have vaginal parturition. The IOS significantly enlarged after vaginal delivery but not after cesarean delivery. There were significant negative correlations between IOS and the recurrence of endometriosis and dysmenorrhea. Odds ratios indicated that as the IOS enlarged, the risk of recurrence decreased.Conclusion(s)Vaginal parturition plays a protective role in the recurrence of endometriosis.

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Condition tags

dysmenorrheaendometriosis

MeSH descriptors

Endometriosis Parturition Uterine Diseases Adolescent Adult Cesarean Section Cesarean Section Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Endometriosis Female Follow-Up Studies Humans Organ Size Parturition Pregnancy Retrospective Studies Secondary Prevention

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