Obstetrical outcome in women with endometriosis including spontaneous hemoperitoneum and bowel perforation: a systematic review

Best Pract Res Clin Obstet Gynaecol. 2018 Aug:51:41-52. doi: 10.1016/j.bpobgyn.2018.01.018. Epub 2018 Feb 21.

Abstract

Increasing evidence suggests that pregnant women with endometriosis have a higher risk of adverse obstetrical complications. The aim of this study was to systematically review the existing literature on this aspect. A PubMed/MEDLINE search was performed from its inception until September 2017 for studies on adverse obstetrical complications in pregnant women with endometriosis, including: preeclampsia, preterm birth, small for gestational age (SGA), antepartum hemorrhage, spontaneous hemoperitoneum, spontaneous bowel perforation, preterm birth, cesarean delivery, stillbirth and postpartum hemorrhage. Overall, the results showed an increased risk of preterm delivery, antepartum hemorrhage, delivery by cesarian section, and the rare complications of spontaneous hemorrhage in pregnancy and spontaneous bowel perforation. There is no firm evidence for any increased risk of preeclampsia, having a child born small for gestational age, stillbirth, or postpartum hemorrhage. In conclusion, pregnant patients with endometriosis should be offered special clinical attention.

Keywords: Antepartum hemorrhage; Bowel perforation; Endometriosis; Hemoperitoneum; Pre-eclampsia; Preterm birth.

Publication types

  • Systematic Review

MeSH terms

  • Case-Control Studies
  • Causality
  • Cesarean Section / statistics & numerical data
  • Cohort Studies
  • Endometriosis / complications
  • Endometriosis / epidemiology*
  • Female
  • Hemoperitoneum / epidemiology
  • Hemoperitoneum / etiology
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Intestinal Perforation / epidemiology
  • Intestinal Perforation / etiology
  • Intestine, Large
  • Postpartum Hemorrhage / epidemiology
  • Postpartum Hemorrhage / etiology
  • Pre-Eclampsia / epidemiology
  • Pre-Eclampsia / etiology
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Premature Birth / epidemiology
  • Premature Birth / etiology
  • Risk Assessment