Endometriosis-associated Maternal Pregnancy Complications – Case Report and Literature Review

Abstract

The incidence of endometriosis is increasing. Particularly during pregnancy and labour, clinicians should be alert to possible endometriosis-associated complications or complications of previous endometriosis treatment, despite a low relative risk. In addition to an increased rate of early miscarriage, complications such as spontaneous bowel perforation, rupture of ovarian cysts, uterine rupture and intraabdominal bleeding from decidualised endometriosis lesions or previous surgery are described in the literature. Unfavourable neonatal outcomes have also been discussed. We report on an irreducible ovarian torsion in the 16th week of pregnancy following extensive endometriosis surgery, and an intraabdominal haemorrhage due to endometriosis of the bowel in the 29th week of pregnancy.

Zusammenfassung

Durch die zunehmende Inzidenz der Endometriose muss, trotz des geringen relativen Risikos, gerade während Schwangerschaft und Entbindung bei diesen Patientinnen an eine Komplikation durch Endometriose oder vorherige Therapie gedacht werden. Neben einer erhöhten Abortrate in der Frühschwangerschaft werden in der Literatur Komplikationen wie spontane Darm- und Ovarialzystenruptur, Uterusruptur sowie intraabdominale Blutungen durch dezidualisierte Endometrioseherde oder vorangegangene Operationen beschrieben. In der Literatur wird sogar ein ungünstigeres neonatales Outcome diskutiert. Wir berichten über eine nicht mehr detorquierbare Stieldrehung in der 16. SSW nach ausgedehnter Endometrioseoperation und eine intraabdominale Blutung bei Darmendometriose in der 29. SSW.

Key words

endometriosis - pregnancy - complication - delivery - decidualization - intraabdominal bleeding

Schlüsselwörter

Endometriose - Schwangerschaft - Komplikation - Hämoperitoneum

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