Objective
A mini-review cases of pregnancy and endomtriosis following the steps of personal clinical cases and literature, considering the fact that while 15-20 % of the fertile couples attempting to become pregnant will be successfull each month, the number drops to 2-10% in couples affected by endometriosis;
Methods
A mini-review of 21 pregnancy cases in female pacients affected by endometriosis-evaluating clinical findings, simptomathology, ultrasounds exams, risks during pregnancy, modality of birth, age, social status, education level, provenience- in a period of 2 years (January 2022- January 2024).
Results
Since according to literature, the first pregnancy apparently happens 4-5 years later in life, than non-endo female patients (34.5%), sooner for the 24-35 years old age group. As simptomathology-some of them -22% exprience impaired status (maybe cause of increased progesteron), but a lot more-57 % declared pain, disgravidia, bleeding, while the rest of patients reported no improvement; As risks-35.8% have increased risk for miscarriages- even in the ones with mild endometriosis; preterm birth was 1.5 times more likely and placenta praevia (32.1%) was related consecvently to higher risk for signifiant bleeding and placenta abruption.
Age groups were devided: 18-24, 24-34, 34-44 years old, most of them, having higher educational level (41.2 %, have attended univeristy), and they were 51.6 % from an urban area. We devided the patients in 2 groups: one with necesity of surgical treatment such as cystectomy for ovarian endometriosis, ablation or excision of endometriolic cysts or adesiolysis (11) and those treated only with medication (10); As a result, the ones with surgical treatment have increased rates for C-sections (OR. 4.6L, CI-211-10.10) p<0.01.
Conclusion
As simptomatology (disgravidia, abdominal pain, vaginal bleeding, recurent abortions), was higher than in pregnant women with no endometriosis, and the increased risks for C section, following placente praevia, abruption etc.- these are enough baselines to approach a new algoritm of the diagnosis and treatment, based on specific needs this type of pregnancy. There is more to learn and study about a disease like endometriosis, affecting more and more women and requiring needs for special healthcare
Keywords
Endometriosis, pregancy, equity, algoritm, healthcare