title: Maternal and neonatal outcomes in women with colorectal endometriosis.
abstract: OBJECTIVE
  To evaluate delivery and neonatal outcomes in women with resected or in situ bowel endometriosis.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  France.
  
  
  METHODS
  Analysis of 72 pregnancies from 67 women followed for colorectal endometriosis from 2001 to 2014 in six centres including two university expert centres for endometriosis.
  
  
  METHODS
  Univariate analysis of maternal and neonatal outcomes.
  
  
  METHODS
  Routes for delivery and rate of complications.
  
  
  RESULTS
  The colorectal surgery group comprised 41 women and the in situ colorectal group, 26 women. Overall, half of the women underwent caesarean section. A high incidence of postoperative complications (39%) was observed after caesarean section with no difference between the groups. Surgical difficulties at newborn extraction (22%) and postoperative complications (39%) occurred more often in women with anterior deep infiltrating endometriosis (respectively 63 versus 11%, P = 0.007 and 67% versus 26%, P = 0.046) independently of prior surgery for endometriosis. In the remaining half, vaginal delivery required an operative procedure in 28% of the women with a significant increase in postpartum complications compared with those who did not require a procedure (P = 0.001). Overall, the incidence of postpartum complications was lower after vaginal delivery (14%) than after caesarean section (39%) (P = 0.03).
  
  
  CONCLUSIONS
  Pregnant women with colorectal endometriosis, irrespective of prior surgery, should be informed of the high risk of delivery by caesarean section. Vaginal delivery is preferrable in this setting because of the lower incidence of postpartum complications.
  
  
  CONCLUSIONS
  Due to the incidence of postpartum complications whatever the route of delivery, women should receive level III maternal care.
authors.affiliation: Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France.|GRC 6 UPMC (C3E) Centre Expert en Endométriose, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Thomin
authors.affiliation: Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France.|GRC 6 UPMC (C3E) Centre Expert en Endométriose, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Belghiti
authors.affiliation: Department of Gynaecology and Obstetrics, Rouen University Hospital, Hospital-Charles Nicolle, Rouen, France.
authors.forename: C
authors.initials: C
authors.lastname: David
authors.affiliation: Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France.|GRC 6 UPMC (C3E) Centre Expert en Endométriose, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Marty
authors.affiliation: Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France.|GRC 6 UPMC (C3E) Centre Expert en Endométriose, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Bornes
authors.affiliation: Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France.|GRC 6 UPMC (C3E) Centre Expert en Endométriose, Paris, France.|UMRS938, Université Pierre et Marie Curie, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Ballester
authors.affiliation: Department of Gynaecology and Obstetrics, Rouen University Hospital, Rouen, France.|Research Group 4308, Spermatogenesis and Gamete Quality, IHU Rouen Normandy, IFRMP23, Reproductive Biology Laboratory, Rouen University Hospital, Rouen, France.
authors.forename: H
authors.initials: H
authors.lastname: Roman
authors.affiliation: Department of Gynaecology and Obstetrics, Hôpital Tenon, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, Paris, France.|GRC 6 UPMC (C3E) Centre Expert en Endométriose, Paris, France.|UMRS938, Université Pierre et Marie Curie, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Daraï
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects* / Q000379:methods; D003108:Colonic Diseases / Q000601:surgery*; D036861:Delivery, Obstetric / Q000009:adverse effects* / Q000379:methods; D004715:Endometriosis / Q000601:surgery*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Caesarean section; colorectal endometriosis; delivery complications; maternal outcomes; neonatal outcomes; postpartum complications