OC06.02: Isolated adenomyosis: a placental risk?

To investigate the correlation between sonographic adenomyosis and placental-associated obstetric complications. A retrospective cohort of patients referred for a targeted ultrasound due to complaints associated with endometriosis/adenomyosis over 12 years (2010-2022) period. The study group comprised patients with adenomyosis sonographic features and the control group included patients with normal sonographic features. Patients diagnosed with endometriosis, uterine fibroids, uterine anomalies, and patients whose mode of conception relied on assisted reproduction technologies were excluded. All images were revised for diagnosis of adenomyosis by an ultrasound specialist. Cases were included if performed up to 5 years from the index birth. The primary outcome was a composite outcome of placental-associated adverse outcomes (preterm labour, small-for-gestational-age fetus, hypertensive disorders of pregnancy, placental abruption, and postpartum hemorrhage). A total of 93 patients diagnosed with adenomyosis and 113 controls were included in the study. There were no clinically significant differences between the groups regarding patients' demographic characteristics. The adenomyosis group had a significantly higher rate of placental-associated adverse complications than controls (28% vs. 11% p < 0.01). Furthermore, when examining obstetrical complications separately, preterm labour (12% vs. 4.4% p < 0.05) and hypertensive disorders of pregnancy (11% vs. 2.7% p < 0.05) were significantly increased in the adenomyosis patients compared to controls. A higher tendency of Caesarean delivery (33% vs. 22%, p < 0.072) and placental abruption (3% vs. 0%, p < 0.09) was also demonstrated in the research group. Adenomyosis was independently significantly associated with placental-associated adverse obstetrical outcomes. Future prospective studies may establish the correlation between specific sonographic features of adenomyosis and the quality of placental function.