Endometriosis and adverse pregnancy outcome

Felice Sorrentino, DE Padova M, Maristella DE PADOVA, Falagario M, Maddalena FALAGARIO, Maurizio N D'Alteri O, Maurizio Nicola D’Alterio, Maurizio N. D’ALTERI O, Attilio Di Spiezio Sardo, Pacheco LA, Luis A. PACHECO, Jose T. CARUGNO, Carugno JT, Luigi Nappi, Nappi L
Minerva obstetrics and gynecology · 2021 · vol. 74(1) , pp. 31–44 · doi:10.23736/s2724-606x.20.04718-8 · PMID:34096691 · W3171195819
Review OA: closed CC0 ⤵ 17 in-corpus citations
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-08 ⓘ

This review examines the diagnosis and evolution of endometriosis during pregnancy, finding a contradictory correlation with adverse outcomes except for miscarriage and cesarean delivery.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

INTRODUCTION: Endometriosis is a gynecologic disease affecting approximately 10% of reproductive age women, around 21-47% of women presenting subfertility and 71-87% of women with chronic pelvic pain. Main symptoms are chronic pelvic pain, dysmenorrhea, dyspareunia and infertility that seem to be well controlled by oral contraceptive pill, progestogens, GnRh antagonists. The aim of this review was to illustrate the modern diagnosis of endometriosis during pregnancy, to evaluate the evolution of endometriotic lesions during pregnancy and the incidence of adverse outcomes. EVIDENCE ACQUISITION: Published literature was retrieved through searches of the database PubMed (National Center for Biotechnology Information, US National Library of Medicine, Bethesda, MD, USA). We searched for all original articles published in English through April 2020 and decided to extract every notable information for potential inclusion in this review. The search included the following MeSH search terms, alone or in combination: "endometriosis" combined with "endometrioma," "biomarkers," "complications," "bowel," "urinary tract," "uterine rupture," "spontaneous hemoperitoneum in pregnancy" and more "adverse pregnancy outcome," "preterm birth," "miscarriage," "abruption placentae," "placenta previa," "hypertensive disorder," "preeclampsia," "fetal grow restriction," "small for gestation age," "cesarean delivery." EVIDENCE SYNTHESIS: Pregnancy in women with endometriosis does not always lead to disappearance of symptoms and decrease in the size of endometriotic lesions, but it may be possible to observe a malignant transformation of ovarian endometriotic lesions. Onset of complications may be caused by many factors: chronic inflammation, adhesions, progesterone resistance and a dysregulation of genes involved in the embryo implantation. As results, the pregnancy can be more difficult because of endometriosis related complications (spontaneous hemoperitoneum [SH], bowel complications, etc.) or adverse outcomes like preterm birth, FGR, hypertensive disorders, obstetrics hemorrhages (placenta previa, abruptio placenta), miscarriage or cesarean section. Due to insufficient knowledge about its pathogenesis, currently literature data are contradictory and do not show a strong correlation between endometriosis and these complications except for miscarriage and cesarean delivery. CONCLUSIONS: Future research should focus on the potential biological pathways underlying these relationships in order to inform patients planning a birth about possible complications during pregnancy.

My notes (saved in your browser only)

Condition tags

endometriosisendometriomachronic_pelvic_paindysmenorrheadyspareuniainfertility

MeSH descriptors

Abortion, Spontaneous Abortion, Spontaneous Abortion, Spontaneous Endometriosis Endometriosis Endometriosis Premature Birth Premature Birth Premature Birth Cesarean Section Cesarean Section Female Female Humans Humans Infant, Newborn Infant, Newborn Pregnancy Pregnancy Pregnancy Outcome

Citation neighborhood (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (100)

Cited by (19)

Source provenance

europepmc
last seen: 2026-10-17T06:09:56.316927+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-10-08T21:31:13.178069+00:00
unpaywall
last seen: 2026-10-17T06:24:38.187582+00:00
License: CC0 · commercial use OK