BiRDeE – Birth Register for Deep Endometriosis: Collection of delivery data from women with deep endometriosis (with and without prior surgery)

Julia Lastinger, Peter Oppelt, Patrick Stelzl, Katrin Oberfichtner, SH Enzelsberger
In: Zeitschrift für Geburtshilfe und Neonatologie · 2025 · vol. 229 · doi:10.1055/s-0045-1813844 · W4417211271
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The BiRDeE study collected delivery data from women with deep endometriosis, finding a high rate of cesarean sections despite vaginal delivery not being contraindicated.

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The BiRDeE study (Birth Register for Deep Endometriosis) investigated delivery and peripartum parameters in women with diagnosed deep endometriosis (DE), including obstetric injuries, delivery mode, and neonatal outcomes, using an international, noninterventional multicenter patient register of singleton live births after DE diagnosis (both operated and non-operated). Participating obstetric facilities entered data via a secure web-based system after ethics approval and registration in DRKS (DRKS00016768). From 257 analyzed cases (after drop-out criteria), delivery modes were reported as spontaneous vaginal (38.5%), instrumental vaginal (12.9%), planned primary cesarean (28.0%), and unplanned secondary cesarean (20.6%), with a median gestational age of 40 weeks and a preterm delivery rate of 10.1%. The paper notes that DE per se is not presented as a contraindication to vaginal delivery, while emphasizing the observed high cesarean rate and referring to an already published interim analysis. This paper is centrally about endometriosis — it establishes and reports initial findings from an international birth register focused on deep endometriosis and delivery outcomes.

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Background

Recent research has shed light on the impact of endometriosis on complications during pregnancy, but very few studies address the influence of deep endometriosis (DE) on delivery and peripartum parameters. For this reason, an international birth register for DE was established to aid in counseling affected women on delivery mode and individual risks. The main focus is to collect information on obstetric injuries, delivery mode and neonatal outcome in women with DE.

Methods

The BiRDeE study (Birth Register for Deep Endometriosis) is an international noninterventional multicenter study based on a patient register of women with singleton live births after diagnosis of DE (both operated on and non-operated). Healthcare facilities for Obstetrics and Gynecology are invited to participate in the register. After online registration as a study center, the participating facility will receive a specific access link and a password to a secure, center-specific online area (web-based data entry system). The study was approved by the institutional ethics committee of the JKU and registered in the DRKS (ID: DRKS00016768).

Results

To date, 257 entered cases are available for analysis after consideration of all of the drop-out criteria. The mode of delivery was as follows: spontaneous vaginal 38.5% (n=99), instrumental vaginal 12.9% (n=33), primary (planned) cesarean 28.0% (n=72), and secondary (unplanned) cesarean 20.6% (n=53). The median gestational age at delivery was 40 weeks with a preterm delivery rate of 10.1%.

Conclusion

Deep endometriosis per se is not a contraindication to vaginal delivery, but a high rate of cesarean section has been observed. Further information can be found in the already published first interim analysis. We invite clinics to participate in the BiRDeE register to obtain more data ([Abb. 1]). endo-geburtenregister.kepleruniklinikum.at endo-birth.kepleruniklinikum.at Publication History Article published online: 10 December 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

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