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Maternal and neonatal outcomes in women with colorectal endometriosis
Author(s) -
Thomin A,
Belghiti J,
David C,
Marty O,
Bornes M,
Ballester M,
Roman H,
Daraï E
Publication year - 2018
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.14221
Subject(s) - medicine , endometriosis , caesarean section , vaginal delivery , obstetrics , incidence (geometry) , population , pregnancy , univariate analysis , gynecology , retrospective cohort study , surgery , multivariate analysis , optics , biology , genetics , physics , environmental health
Objective To evaluate delivery and neonatal outcomes in women with resected or in situ bowel endometriosis. Design Retrospective cohort study. Setting France. Population and sample 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. Main outcome measures 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). Conclusion 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. Tweetable abstract Due to the incidence of postpartum complications whatever the route of delivery, women should receive level III maternal care.