title: Complications during pregnancy and delivery in women with untreated rectovaginal deep infiltrating endometriosis.
abstract: OBJECTIVE
  To study outcomes and complications during pregnancy and at delivery in women with a posterior deep infiltrating endometriosis (DIE) nodule persisting after surgery and diagnosed at transvaginal sonography (TVS) in comparison with a control group of women without endometriosis.
  
  
  METHODS
  Multicenter observational and cohort study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Women (n = 200) with a posterior DIE nodule equal or more than 2 cm centimeters in size who desired a pregnancy and a control group of women (n = 300) with no previous recorded diagnosis of endometriosis who delivered in our clinic during the same time period.
  
  
  METHODS
  Patient data collected from medical charts and by phone interviews.
  
  
  METHODS
  Evaluation of complications during pregnancy and delivery.
  
  
  RESULTS
  Of the 101 women with a posterior DIE nodule, 52 become pregnant among whom 25 used assisted reproductive technology. Of these 52 pregnancies, 11 ended in an early abortion, and 41 delivered a baby; 13 (31.7%) had a premature delivery, 7 (17.8%) a placenta praevia, and 28 (68.2%) had a cesarean delivery. When compared with the control group, the women with endometriosis had a higher risk of pregnancy complicated by preterm birth, placenta previa, placental abruption, and hypertension. Cesarean delivery and complications during surgery (hysterectomy, hemoperitoneum, and bladder injuries) were statistically significantly more frequent in women with endometriosis than in controls.
  
  
  CONCLUSIONS
  Women with an incomplete removal of posterior DIE have a high complications rate during pregnancy and delivery.
authors.affiliation: Department of Biomedicine and Prevention Obstetrics and Gynecological Clinic, University of Rome "Tor Vergata," Rome, Italy. Electronic address: caterinaexacoustos@tiscali.it.
authors.forename: Caterina
authors.initials: C
authors.lastname: Exacoustos
authors.affiliation: Department of Obstetrics and Gynecology, University of Parma, Parma, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Lauriola
authors.affiliation: Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, Siena, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Lazzeri
authors.affiliation: Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, Siena, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: De Felice
authors.affiliation: Department of Biomedicine and Prevention Obstetrics and Gynecological Clinic, University of Rome "Tor Vergata," Rome, Italy.
authors.forename: Errico
authors.initials: E
authors.lastname: Zupi
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002585:Cesarean Section / Q000009:adverse effects; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004715:Endometriosis / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D007558:Italy; D050498:Live Birth; D036801:Parturition; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000209:etiology*; D011446:Prospective Studies; D012002:Rectal Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D027724:Reproductive Techniques, Assisted; D012307:Risk Factors; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal; D014623:Vaginal Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D055815:Young Adult
keywords: Complications at delivery; deep infiltrating endometriosis (DIE); pregnancy complications; transvaginal ultrasound (TVS)