Zhao Tian , Jin Lai , Qing-Jie Zhai , Yi Li , Yue Wang , Xiao-Hong Chang , Hong-Lan Zhu , Heng Cui
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The demographic characteristics and pregnancy outcomes were compared between women with adenomyosis only and those with the surgical history of endometriosis.</p></div><div><h3>Results</h3><p>Compared with women with adenomyosis only, those concomitant with the surgical history of endometriosis had significantly higher age at delivery [37.5(36.25–39.75) vs. 35(33.25–37), P = 0.016] and an increased risk of postpartum hemorrhage (PPH) (adjusted OR: 5.992, 95% CI: 1.03–34.857, P = 0.046) while no significant differences were found in other adverse pregnancy outcomes between these two groups. Then we further detected the risk factor of PPH in women with adenomyosis and found that the surgical history of endometriosis (OR: 6.995, 95% CI: 1.16–42.171, P = 0.034) and assisted reproductive technology (ART) (OR: 5.062, 95% CI: 1.494–17.146, P = 0.009) were the parameters closely associated with the occurrence of PPH.</p></div><div><h3>Conclusions</h3><p>The history of previous laparoscopic surgical and pathological diagnosis of endometriosis in pregnant women with adenomyosis may increase the risk of PPH, which still needs to be verified by future studies with a large sample size. Besides, pregnancy through ART is also an increased risk factor for PPH in women with adenomyosis. Pregnant women with adenomyosis who conceived with the surgical history of endometriosis or by ART should be closely monitored for the reason of being at high risk of PPH.</p></div>","PeriodicalId":34826,"journal":{"name":"Gynecology and Obstetrics Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667164622000562/pdfft?md5=7a0227a13b865e5b9d634d46b9560d78&pid=1-s2.0-S2667164622000562-main.pdf","citationCount":"1","resultStr":"{\"title\":\"Influence of previous laparoscopic surgical and pathological diagnosis of endometriosis on pregnancy outcomes in women with adenomyosis\",\"authors\":\"Zhao Tian , Jin Lai , Qing-Jie Zhai , Yi Li , Yue Wang , Xiao-Hong Chang , Hong-Lan Zhu , Heng Cui\",\"doi\":\"10.1016/j.gocm.2022.07.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objectives</h3><p>Previous studies demonstrated that endometriosis and adenomyosis are closely linked to lots of adverse pregnancy outcomes while the role of endometriosis in pregnant women with adenomyosis has not been explored yet. The present study aimed to evaluate the influence of previous laparoscopic surgical and pathological diagnosis of endometriosis on pregnancy outcomes in women with adenomyosis.</p></div><div><h3>Methods</h3><p>A total of 60 pregnant women who were diagnosed with adenomyosis before or during pregnancy were included in this study. Among them, 8 were also diagnosed with endometriosis by previous laparoscopic surgery. The demographic characteristics and pregnancy outcomes were compared between women with adenomyosis only and those with the surgical history of endometriosis.</p></div><div><h3>Results</h3><p>Compared with women with adenomyosis only, those concomitant with the surgical history of endometriosis had significantly higher age at delivery [37.5(36.25–39.75) vs. 35(33.25–37), P = 0.016] and an increased risk of postpartum hemorrhage (PPH) (adjusted OR: 5.992, 95% CI: 1.03–34.857, P = 0.046) while no significant differences were found in other adverse pregnancy outcomes between these two groups. Then we further detected the risk factor of PPH in women with adenomyosis and found that the surgical history of endometriosis (OR: 6.995, 95% CI: 1.16–42.171, P = 0.034) and assisted reproductive technology (ART) (OR: 5.062, 95% CI: 1.494–17.146, P = 0.009) were the parameters closely associated with the occurrence of PPH.</p></div><div><h3>Conclusions</h3><p>The history of previous laparoscopic surgical and pathological diagnosis of endometriosis in pregnant women with adenomyosis may increase the risk of PPH, which still needs to be verified by future studies with a large sample size. Besides, pregnancy through ART is also an increased risk factor for PPH in women with adenomyosis. 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引用次数: 1
摘要
目的以往的研究表明，子宫内膜异位症和子宫腺肌症与许多不良妊娠结局密切相关，但尚未探讨子宫内膜异位症在子宫腺肌症孕妇中的作用。本研究旨在评估以往腹腔镜手术和病理诊断子宫内膜异位症对子宫腺肌症妇女妊娠结局的影响。方法本研究共纳入60例孕前或孕期诊断为子宫腺肌症的孕妇。其中8例既往腹腔镜手术诊断为子宫内膜异位症。比较了仅有子宫腺肌症和有子宫内膜异位症手术史的妇女的人口统计学特征和妊娠结局。结果合并子宫内膜异位症的分娩年龄(37.5(36.25-39.75)vs. 35(33.25-37)， P = 0.016)明显高于单纯子宫内膜异位症患者，产后出血(PPH)风险增加(调整OR: 5.992, 95% CI: 1.03-34.857, P = 0.046)，其他不良妊娠结局两组间差异无统计学意义。进一步检测子宫腺肌症女性PPH的危险因素，发现子宫内膜异位症手术史(OR: 6.995, 95% CI: 1.16 ~ 42.171, P = 0.034)和辅助生殖技术(OR: 5.062, 95% CI: 1.494 ~ 17.146, P = 0.009)是与PPH发生密切相关的参数。结论子宫腺肌症孕妇既往腹腔镜手术史及子宫内膜异位症的病理诊断可能会增加PPH的发生风险，这有待于未来大样本量的研究证实。此外，通过抗逆转录病毒治疗怀孕也是bbb妇女PPH风险增加的因素。有子宫内膜异位症手术史或接受过抗逆转录病毒治疗的子宫腺肌症孕妇因其PPH风险高，应密切监测。
Influence of previous laparoscopic surgical and pathological diagnosis of endometriosis on pregnancy outcomes in women with adenomyosis
Objectives
Previous studies demonstrated that endometriosis and adenomyosis are closely linked to lots of adverse pregnancy outcomes while the role of endometriosis in pregnant women with adenomyosis has not been explored yet. The present study aimed to evaluate the influence of previous laparoscopic surgical and pathological diagnosis of endometriosis on pregnancy outcomes in women with adenomyosis.
Methods
A total of 60 pregnant women who were diagnosed with adenomyosis before or during pregnancy were included in this study. Among them, 8 were also diagnosed with endometriosis by previous laparoscopic surgery. The demographic characteristics and pregnancy outcomes were compared between women with adenomyosis only and those with the surgical history of endometriosis.
Results
Compared with women with adenomyosis only, those concomitant with the surgical history of endometriosis had significantly higher age at delivery [37.5(36.25–39.75) vs. 35(33.25–37), P = 0.016] and an increased risk of postpartum hemorrhage (PPH) (adjusted OR: 5.992, 95% CI: 1.03–34.857, P = 0.046) while no significant differences were found in other adverse pregnancy outcomes between these two groups. Then we further detected the risk factor of PPH in women with adenomyosis and found that the surgical history of endometriosis (OR: 6.995, 95% CI: 1.16–42.171, P = 0.034) and assisted reproductive technology (ART) (OR: 5.062, 95% CI: 1.494–17.146, P = 0.009) were the parameters closely associated with the occurrence of PPH.
Conclusions
The history of previous laparoscopic surgical and pathological diagnosis of endometriosis in pregnant women with adenomyosis may increase the risk of PPH, which still needs to be verified by future studies with a large sample size. Besides, pregnancy through ART is also an increased risk factor for PPH in women with adenomyosis. Pregnant women with adenomyosis who conceived with the surgical history of endometriosis or by ART should be closely monitored for the reason of being at high risk of PPH.
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