Association Between Pre-Conception Surgery for Deep Endometriosis and Adverse Obstetric Outcomes: A Retrospective Cohort Study

Yannick Hurni, Nuria Barbany-Freixa, Barbany-Freixa N, Nuria Barbany‐Freixa, Manosalvas-Escobar L, Laura Manosalvas-Escobar, Castellví-Ibáñez I, Inés Castellví-Ibáñez, Pascual MÁ, María Ángela Pascual, M. Pascual, García-Martínez S, Sandra García-Martínez, Pilar Prats-Rodríguez, Prats-Rodríguez P, Silvia Cabrera, Sílvia Cabrera, Barri-Soldevila PN, Pere N Barri-Soldevila
Journal of Minimally Invasive Gynecology · 2026 · doi:10.1016/j.jmig.2026.06.006 · PMID:42285429 · W7164544094
Observational OA: closed
View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-07-09 ⓘ

Pre-conception surgery for deep endometriosis was associated with increased adverse maternal obstetric outcomes compared to conservative management in nulliparous women.

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

Abstract

STUDY OBJECTIVE: To evaluate whether pre-conception surgery for deep endometriosis (DE) is associated with obstetric outcomes compared with conservative management. DESIGN: Retrospective cohort study. SETTING: Single-center tertiary hospital. PATIENTS: Nulliparous women with singleton pregnancies and diagnosed DE who delivered between 2017 and 2024. INTERVENTIONS: Pre-conception surgery for DE. MEASUREMENTS AND MAIN RESULTS: Obstetric outcomes were compared between women undergoing pre-conception DE surgery and those managed non-surgically. The primary outcome was a composite adverse obstetric outcome, including major maternal, fetal, and neonatal complications, analyzed using multivariable logistic regression, adjusted for maternal age, body mass index, adenomyosis, anatomical disease extent (#Enzian classification), and mode of conception, with additional sensitivity analyses to assess robustness. A total of 298 nulliparous women were included, of whom 65.8% (196/298) were managed without surgery, and 34.2% (102/298) underwent pre-conception DE surgery. The composite adverse obstetric outcome occurred in 37.3% (38/102) of the surgery group and 18.9% (37/196) of the no-surgery group (p < .001). After multivariable adjustment, pre-conception surgery remained associated with higher odds of the composite outcome (adjusted OR 2.3, 95% CI 1.2-4.3). The surgery group had higher rates of placenta previa, gestational hypertensive disorders, postpartum hemorrhage, blood transfusion, and cesarean delivery, whereas fetal and neonatal outcomes were comparable between groups. CONCLUSION: Pre-conception surgical treatment of DE was associated with increased maternal obstetric morbidity; however, given the observational design and baseline differences in disease severity, this finding should be interpreted as an association rather than evidence of causation.

My notes (saved in your browser only)

Citation neighborhood

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.

References (21)

Source provenance

europepmc
last seen: 2026-10-12T06:17:10.165071+00:00
openalex
last seen: 2026-08-31T06:00:52.054077+00:00
pubmed
last seen: 2026-10-12T06:10:41.828919+00:00