Effects of Previous Laparoscopic Surgical Diagnosis of Endometriosis on Pregnancy Outcomes

作     者：Hui Li Hong-Lan Zhu Xiao-Hong Chang Yi Li Yue Wang Jing Guan Heng Cui Li Hui;Zhu Hong-Lan;Chang Xiao-Hong;Li Yi;Wang Yue;Guan Jing;Cui Heng

作者机构：Gynecological Oncology Center Peking University People's Hospital Beijing 100044 China Department of Obstetrics and Gynecology Peking University People's Hospital Beijing 100044 China Reproductive Medicine Center Peking University People's Hospital Beijing 100044 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2017年第130卷第4期

页      面：428-433页

核心收录：

学科分类：10[医学] 

基　　金：supported by grants from Peking University People's Hospital Scientific Research Development Funds 国家自然科学基金 

主　　题：Assisted Reproductive Technology Endometriosis Pregnancy Outcomes 

摘      要：Background： The association between the previous history ofendometriosis and obstetric outcomes is still ambiguous. This study aimed to evaluate the effects of previous history of operatively diagnosed endometriosis on pregnancy outcomes. Methods： A total of 98 primiparous women who had been diagnosed with endometriosis by previous laparoscopic surgery were included in this retrospective cohort study. Pregnancy outcomes were compared between these women （study group） who had a live birth and 300 women without endometriosis （control group） who had a live birth. In the study group, the pregnancy outcomes of 74 women who conceived naturally （no assisted reproductive technology [ART] subgroup） were simultaneously compared with 24 women who conceived by ART （ART subgroup）. Results： Miscarriage was observed in 23 of 98 women with endometriosis （23.5%）. There were 75 women who had a live birth after laparoscopic diagnosis ofendometriosis in the study group eventually. On multivariate analysis, the postpartum hemorrhage rate increased significantly in the study group when compared with the control group （adjusted odds ratio： 2.265, 95% confidence interval： 1.062, 4.872; P = 0.034）. There was an upward tendency of developing other pregnancy-related complications, such as preterm birth, placental abruption, placenta previa, cesarean section, fetal distress/anemia, and others in the study group than in the control group. However, the differences showed no statistical significance. Within the study group, the occurrence rate of postpartum hemorrhage and preterm birth was both higher in the ART subgroup than in the no ART subgroup. The differences both had statistical significance （44.4% vs. 17.5%, P = 0.024 and 27.8% vs. 1.8%, P = 0.010, respectively）. At the same time, median （interquartile range） for gestational age at delivery in the ART subgroup was significantly shorter than that in the no ART subgroup （38 weeks [36-39 weeks] vs. 39 weeks [38-40 weeks]; P = 0.005）. Conclus