Maternal and neonatal outcomes in women with colorectal endometriosis

A. Thomin, Thomin A, Belghiti J, J. Belghiti, C David, Carlos David, David C, Marty O, O Marty, Olivier Marty, Bornes M, Marie Bornes, M Bornes, Marcos Ballester, M Ballester, Ballester M, H. Roman, Roman H, Horace Roman, Daraï E, Émile Daraï, E. Daraï
BJOG: An International Journal of Obstetrics & Gynaecology · 2016 · vol. 125(6) , pp. 711–718 · doi:10.1111/1471-0528.14221 · PMID:27428865 · W2497843218
Observational OA: closed CC0 ⤵ 30 in-corpus citations
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This study found that pregnant women with colorectal endometriosis have a high rate of cesarean sections and more complications with operative vaginal deliveries, though overall postpartum complications were lower after vaginal birth compared to cesarean.

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Abstract

OBJECTIVE: To evaluate delivery and neonatal outcomes in women with resected or in situ bowel endometriosis. DESIGN: Retrospective cohort study. SETTING: France. POPULATION AND SAMPLE: Analysis of 72 pregnancies from 67 women followed for colorectal endometriosis from 2001 to 2014 in six centres including two university expert centres for endometriosis. METHODS: Univariate analysis of maternal and neonatal outcomes. MAIN OUTCOME MEASURES: Routes for delivery and rate of complications. RESULTS: The colorectal surgery group comprised 41 women and the in situ colorectal group, 26 women. Overall, half of the women underwent caesarean section. A high incidence of postoperative complications (39%) was observed after caesarean section with no difference between the groups. Surgical difficulties at newborn extraction (22%) and postoperative complications (39%) occurred more often in women with anterior deep infiltrating endometriosis (respectively 63 versus 11%, P = 0.007 and 67% versus 26%, P = 0.046) independently of prior surgery for endometriosis. In the remaining half, vaginal delivery required an operative procedure in 28% of the women with a significant increase in postpartum complications compared with those who did not require a procedure (P = 0.001). Overall, the incidence of postpartum complications was lower after vaginal delivery (14%) than after caesarean section (39%) (P = 0.03). CONCLUSION: Pregnant women with colorectal endometriosis, irrespective of prior surgery, should be informed of the high risk of delivery by caesarean section. Vaginal delivery is preferrable in this setting because of the lower incidence of postpartum complications. TWEETABLE ABSTRACT: Due to the incidence of postpartum complications whatever the route of delivery, women should receive level III maternal care.

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Condition tags

endometriosisdie_deep_infiltratingbowel_endometriosis

MeSH descriptors

Cesarean Section Colonic Diseases Delivery, Obstetric Endometriosis Pregnancy Complications Rectal Diseases Adult Adult Cesarean Section Cesarean Section Cesarean Section Colonic Diseases Colonic Diseases Delivery, Obstetric Delivery, Obstetric Delivery, Obstetric Endometriosis Endometriosis Female Female

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 (39)

Cited by (31)

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