PREGNANCY COMPLICATIONS IN PATIENTS WITH ENDOMETRIOSIS
Keywords:endometriosis, IVF, ART, spontaneous pregnancy, pregnancy complications
Introduction: Endometriosis is a chronic disease, which causes infertility in 40%. In case of ineffective therapy, assisted reproductive technology is indicated. Endometriosis is an independent risk factor for mother and fetus morbidities. Prenatal monitoring, is essential in prevention of pregnancy-related complications.
Objective: Evaluation and comparison the frequency of pregnancy complications in women with endometriosis after traditional treatment methods of infertility and after IVF.
Methods: Retrospective study included 320 patients aged 28-46, with different locations of endometriosis, diagnosed by laparoscopy. The patients were divided into two groups: I group – 170 pregnant women using the fertility treatment method – IVF and II group – 150 pregnant women conceived naturally. Pregnancy complications were evaluated and statistically analyzed.
Results: In pregnant women with endometriosis after IVF treatment the most common pregnancy complication was caesarian section - 79.4%, both emergency and elective. The frequency of preeclampsia was also high - 54.7%. The preterm birth occurred in 49.4%, the same trend was revealed in the II group - 52, 0%. Placenta previa and placenta abruption were rare in both groups 10.6% vs. 4.0% and 3.5% vs. 2%. In general, the adverse pregnancy outcome in the ART group was significantly higher compared to pregnant women conceived naturally except for the preterm delivery and abruption of the placenta.
Conclusions: IVF pregnancy in patients with endometriosis should be considered a high-risk pregnancy regarding adverse outcomes: cesarean section, preeclampsia and preterm delivery. However, these pregnancy complications should be linked to the endometriosis and infertility and may not to the ART.
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