Previous surgery for endometriosis: a further risk for obstetric complications?

This retrospective observational cohort study used prospectively collected data from a single tertiary referral center (2019–2021) to compare pregnancy and delivery outcomes in singleton pregnancies among women with endometriosis who had prior endometriosis surgery versus those managed conservatively. Among 162 cases (103, 63% with one or more surgeries), women with endometriosis overall showed higher incidences of preterm birth, placental disorders, gestational diabetes, caesarean section, and postpartum hemorrhage compared with non-endometriosis patients, and those with surgical history had an additional increase in caesarean section (47%) and postpartum hemorrhage (27%) compared with conservatively managed women. No difference was found for other obstetric complications. The study is limited by its retrospective design and single-center setting, and it specifically focuses on women with endometriosis who were followed and delivered in that high-risk context. This paper is centrally about endometriosis — it evaluates whether prior endometriosis surgery adds risk for adverse obstetric and postpartum outcomes.

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