title: Vaginal parturition decreases recurrence of endometriosis.
abstract: OBJECTIVE
  To evaluate the role of parturition in the recurrence of endometriosis.
  
  
  METHODS
  Retrospectively analyzed, prospectively obtained data.
  
  
  METHODS
  Unit of Physiopathology of Reproduction, Health Care Unit of Rimini, and University of Bologna Cervesi General Hospital, Cattolica, Italy.
  
  
  METHODS
  Three hundred forty-five patients with stage II-IV endometriosis, dysmenorrhea, and infertility were treated for endometriosis and divided into four groups according to parity and mode of parturition.
  
  
  METHODS
  The patients were laparoscopically treated for endometriosis upon the occurrence and recurrence of the disease. Ultrasound measurements of the uterine internal ostium (IOS) were performed at each study interval.
  
  
  METHODS
  Degree of dysmenorrhea, occurrence and recurrence of endometriosis, and uterine IOS measurements were established and related to parity and mode of parturition.
  
  
  RESULTS
  After parturition, dysmenorrhea recurrence was significantly higher in nulliparous women than in women with vaginal parturition. The endometriosis recurrence rate was higher in women who did not have vaginal parturition. The IOS significantly enlarged after vaginal delivery but not after cesarean delivery. There were significant negative correlations between IOS and the recurrence of endometriosis and dysmenorrhea. Odds ratios indicated that as the IOS enlarged, the risk of recurrence decreased.
  
  
  CONCLUSIONS
  Vaginal parturition plays a protective role in the recurrence of endometriosis.
authors.affiliation: Unit of Physiopathology of Reproduction, Cattolica General Hospital and University of Bologna, Bologna, Italy. bulleticarlo@libero.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Bulletti
authors.forename: Anna
authors.initials: A
authors.lastname: Montini
authors.forename: Paolo Levi
authors.initials: PL
authors.lastname: Setti
authors.forename: Antonio
authors.initials: A
authors.lastname: Palagiano
authors.forename: Filippo
authors.initials: F
authors.lastname: Ubaldi
authors.forename: Andrea
authors.initials: A
authors.lastname: Borini
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D004412:Dysmenorrhea / Q000473:pathology; D004715:Endometriosis / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009929:Organ Size; D036801:Parturition / Q000502:physiology*; D011247:Pregnancy; D012189:Retrospective Studies; D055502:Secondary Prevention; D014591:Uterine Diseases / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D014599:Uterus / Q000033:anatomy & histology / Q000473:pathology; D014621:Vagina / Q000033:anatomy & histology / Q000473:pathology; D055815:Young Adult