Endometriosis and impaired placentation: a prospective cohort study comparing uterine arteries Doppler pulsatility index in pregnancies of patients with and without moderate-severe disease

Noemi Salmeri, Farina A, Antonio Farina, Candiani M, Massimo Candiani, Carolina Dolci, Dolci C, Giulia Bonavina, Bonavina G, Paola Viganò, Viganò P, Paolo Ivo Cavoretto
In: Authorea, Inc. · 2024 · doi:10.22541/au.170670968.82836468/v1 · W4391402759
preprint OA: gold CC0
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Moderate-severe endometriosis (r-AFS stage III-IV) is associated with increased uterine artery pulsatility index Z-scores in the third trimester of pregnancy, indicating impaired placental perfusion.

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Abstract

Objective: To evaluate if moderate-severe endometriosis impairs uterine arteries pulsatility index (UtA-PI) during pregnancy when compared to unaffected controls. Design: Observational prospective cohort study. Setting: University-affiliated obstetrics and fetal medicine Department in Italy. Population: Pregnant women with stage III-IV endometriosis according to revised American Fertility Society (r-AFS) classification, matched in a 1:2 ratio according with body mass index and parity with unaffected controls. Methods: UtA-PIs were assessed at 11–14, 19–22 and 26–34 weeks of gestation following major reference guidelines. A General Linear Model (GLM) was implemented to evaluate the association between endometriosis and UtA-PI Z-scores. Main Outcome Measure: UtA-PI Z-scores, calculated from published reference equations of previously validated normal range. Results: Significantly higher third trimester UtA-PI Z-scores were observed in patients with r-AFS stage III-IV endometriosis when compared to controls (p=0.024). In the GLM, endometriosis (p=0.026) and maternal age (p=0.007) were associated with increased third trimester UtA-PI Z-scores, whereas conception by in-vitro fertilization with frozen-thawed embryo transfer significantly decreased UtA-PI measures (p=0.011). No differences were observed in first or in second trimester UtA-PI Z-scores of cases vs. controls. Conclusions: Stage III-IV endometriosis according to r-AFS classification is associated with a clinically measurable impaired placental perfusion as shown by increased UtA-PI Z-scores in the third, but not in the first or second trimesters. Closer follow-up may be recommended in pregnant patients affected by moderate-severe endometriosis in order to attempt prediction and prevention of adverse pregnancy/perinatal outcomes due to a defective late placental perfusion. Funding: N/A.

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Condition tags

endometriosis

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 (42)

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