Issues obstétricales des grossesses obtenues par Assistance médicale à la procréation chez les femmes endométriosiques

Carassou-Maillan A, A. Carassou-Maillan, Pouly JL, J.-L. Pouly, Aurélien Mulliez, A Mulliez, Mulliez A, Dejou-Bouillet L, L Dejou-Bouillet, Lydie Dejou-Bouillet, Gremeau AS, A.-S. Grémeau, A.-S. Gremeau, F Brugnon, Florence Brugnon, Brugnon F, Janny L, L. Janny, M Canis, Michel Canis
Gynecologie, obstetrique & fertilite · 2014 · vol. 42(4) , pp. 210–215 · doi:10.1016/j.gyobfe.2014.01.012 · PMID:24679602 · W1983890176
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This paper reviews the obstetric complications observed in pregnancies conceived via assisted reproductive technologies among women diagnosed with endometriosis.

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Abstract

ObjectiveWhile association between endometriosis and infertility is well established, there are few studies about the impact of endometriosis on adverse pregnancy outcomes. The aim of this study was to determine the effect of endometriosis on obstetric outcomes and whether the severity of the disease had an influence on these.Patients and methodsWe performed a retrospective study to investigate the obstetric outcomes of a population of 1204 subfertile women, including 258 with endometriosis, who obtained, thanks to assisted reproduction technology, a singleton pregnancy evolving beyond embryonic stage. Two analyzes were performed. The first compared women with endometriosis to women with other causes of infertility. The second observed adverse pregnancy outcomes according to AFS-R stages of endometriosis.ResultsThe overall rate of live birth children was 95.8%. In case of endometriosis, there was a significant increase of the incidence of preterm delivery, especially before 32 weeks amenorrhea (6.2% vs 3.1% in the group "without endometriosis", P = 0.03), antenatal bleeding (5.3% vs 2.2%, P = 0.01) and placenta previa (4.9% vs 0.9%, P < 0.0001). The incidence of gestational diabetes was significantly decreased (0.4% vs 2.7%, P = 0.04). There was no correlation between endometriosis and cesarean section or preeclampsia, or between the AFS-R stage and adverse pregnancy outcomes.Discussion and conclusionEndometriosis is a factor of obstetrical risk, independently of the infertility it causes. The AFS-R score does not seem to be representative of obstetric outcomes beyond first trimester of pregnancy for women with endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Pregnancy Complications Pregnancy Outcome Reproductive Techniques, Assisted Adult Endometriosis Endometriosis Female Humans Infertility, Female Infertility, Female Infertility, Female Pregnancy Premature Birth Premature Birth Retrospective Studies Risk Factors

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