Endometriosis During Pregnancy: Maternal and Fetal Considerations

Mehmet Çopuroğlu
In: Endometriosis - Medical Aspects and Modern Approaches [Working Title] · 2026 · doi:10.5772/intechopen.1015030 · W7155226027
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

Pregnancy does not always suppress endometriosis, which can pose risks for maternal and fetal health, particularly with deeper or more extensive disease requiring individualized management.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This paper is a comprehensive overview of how endometriosis behaves during pregnancy, integrating evidence on pathophysiology, the clinical course, diagnostic challenges, and maternal and fetal/neonatal outcomes, with attention to heterogeneity by phenotype, disease extent, and prior surgery. It summarizes mechanistic findings such as progesterone resistance in lesions, continued intracrine estrogen production, decidualization that can increase lesion vascularity and friability, immune dysregulation at the maternal–fetal interface, and dysregulated angiogenesis/VEGF signaling that may contribute to placental implantation and vascular remodeling problems. The chapter notes major caveats including limited prospective data and a lack of phenotype-specific, evidence-based guidelines, while acknowledging that many pregnancies are uncomplicated and higher risks are more associated with deep infiltrating or extensive disease. This paper is centrally about endometriosis — it specifically focuses on maternal and fetal considerations and obstetric outcomes of endometriosis during pregnancy.

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Abstract

Endometriosis is a chronic inflammatory condition traditionally viewed as hormonally suppressed during pregnancy. However, growing evidence indicates that pregnancy does not uniformly mitigate disease activity and that endometriosis may have clinically relevant implications for both maternal and fetal health. This chapter provides a comprehensive overview of endometriosis in the context of pregnancy, integrating current knowledge on pathophysiology, clinical course, diagnostic challenges, maternal complications, and fetal and neonatal outcomes. Particular emphasis is placed on the heterogeneity of the disease, highlighting how pregnancy risks vary according to endometriosis phenotype, disease extent, and prior surgical history. The chapter also addresses management strategies during pregnancy, postpartum considerations, and the importance of individualized risk stratification and multidisciplinary care. While many women with endometriosis experience uncomplicated pregnancies, those with deep infiltrating or extensive disease may face increased risks of placental dysfunction, preterm birth, and operative delivery. Persistent gaps in evidence, including limited prospective data and a lack of phenotype-specific guidelines, are discussed alongside future research priorities. Overall, this chapter reframes endometriosis as a condition of obstetric relevance and underscores the need for tailored, evidence-informed approaches to optimize maternal and fetal outcomes throughout pregnancy and the postpartum period.

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endometriosis

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References (55)

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last seen: 2026-06-10T17:14:06.276822+00:00
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