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

81 Ital J Gynaecol Obstet 2023, 35, Supplement N.1 Abstract Previous surgery for endometriosis: a further risk for obstetric complications? Silvia Vannuccini, Francesco La Torre *, Ernesto Gallucci, Federico Toscano, Agostino Ruotolo, Tommaso Capezzuoli, Federico Mecacci, Felice Petraglia Careggi University Hospital, University of Florence, Florence, Italy. DOI: 10.36129/jog.2022.S80 Objective. A number of evidence has shown that endome- triosis is associated with an increased incidence of obstetric complications, but it is still unknown if other variables relat- ed to the disease influence the outcome. Thus, the aim of the study was to evaluate whether a history of surgery represents an additional risk factor for adverse pregnancy and delivery outcome among women with endometriosis. Materials and Methods. A retrospective observational cohort study on prospectively collected data was conducted in a sin- gle tertiary referral center for both endometriosis and high-risk pregnancy between 2019 and 2021. Women with a history of endometriosis, diagnosed either by imaging or by histological confirmation after surgery, who were followed up and deliv- ered after singleton pregnancy were included. Women with and without previous surgical treatment for endometriosis were compared in terms of maternal characteristics, mode of concep- tion, pregnancy management, obstetric complications, delivery and postpartum outcome, pregnancy and delivery outcome. Results. The study population included 162 cases and 103 (63%) had 1 or more surgery for endometriosis. A high inci- dence of preterm births, placental disorders, gestational dia- betes, caesarean section (CS) and postpartum haemorrhage (PPH) was found compared to non-endometriosis patients. However, women with a history of surgery for endometrio- sis had further increase of CS (47%) and PPH rate (27%) com- pared to those conservatively managed. No difference was found in terms of other obstetric complications. Conclusions. Pregnant women with a history of surgery for endometriosis should be considered at high risk for peripar - tum and postpartum adverse outcomes.