Beyond infertility: Obstetrical and postpartum complications associated with endometriosis and adenomyosis
Open accessAbstract
The risk of pregnancy and neonatal complications in women with endometriosis and adenomyosis is debatable. A literature review looking at rates, presentation, and management of spontaneous hemoperitoneum, enlargement, abscess, and rupture of an endometrioma, uterine rupture, and bowel perforation in pregnant women with endometriosis was conducted. Moreover, studies addressing differences in early pregnancy (miscarriage), late pregnancy (gestational diabetes mellitus, preeclampsia, prematurity, placenta previa, placental abruption, cesarean section, hemorrhages) and neonatal outcomes (weight at birth) between endometriosis and adenomyosis patients versus control subjects were reviewed. The overall prevalence of endometriosis-related spontaneous hemoperitoneum in pregnancy is estimated to be ∼0.4%. Only four cases of endometrioma rupture in pregnancy have been reported. Although during pregnancy there is no way to anticipate the onset of complications from preexisting endometriosis, it is important, when a specific abdominal pain occurs, to suspect rare but potentially life-threating events. Population-based studies suggest a possible association of endometriosis with preterm birth and placenta previa. Limits of the published studies are noted and discussed.
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AM-associated disruption of the junctional zone and inner myometrium may lead to placental implantation disorders.
“AM-associated disruption of the junctional zone and the inner myometrium may lead to placental implantation disorders [29,30,31,32].”
From Women with Endometriosis—Who Is at Risk for Complications Associated with Pregnancy and Childbirth? A Retrospective Case–Control Study (2024) · cites this paper as [31]
Instead of becoming at rest during pregnancy, some deep lesions do progress and can cause bowel, uterus, or bladder perforations.
“Instead of becoming at rest during a pregnancy, some deep lesions do progress and can cause bowel (65,66), uterus, or bladder perforations.”
From Pathogenesis of deep endometriosis (2017) · cites this paper as [66]
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“Bowel perforations have been reported during pregnancy (66, 67) and estrogen-progestin treatment (68).”
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“It is already known that adenomyosis has adverse obstetric effects such as premature birth, preterm rupture of the membranes, and live birth rate [100].”
BackgroundDueholm, M. (2017) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1111/aogs.13158 · Cited by 113 · see citing works
Exacoustos, C., Lauriola, I., Lazzeri, L., De Felice, G., & Zupi, E. (2016) · Fertility and Sterility · doi:10.1016/j.fertnstert.2016.06.024 · Cited by 100 · see citing works
Adenomyosis and Infertility—Review of Medical and Surgical Approaches
Szubert, M., Koziróg, E., Olszak, O., Krygier-Kurz, K., Kaźmierczak, J., & Wilczyński, J. R. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18031235 · Cited by 99 · see citing works
“In addition, adenomyosis enhances the risk of obstetric complications, such as premature birth and preterm rupture of the amniotic membranes [18,19].”
BackgroundPregnancy outcome in women with endometriosis achieving pregnancy with IVF
Benaglia, L., Candotti, G., Papaleo, E., Pagliardini, L., Leonardi, M., Reschini, M., Quaranta, L., Munaretto, M., Viganò, P., Candiani, M., et al. (2016) · Human Reproduction · doi:10.1093/humrep/dew210 · Cited by 95 · see citing works
“Some recent epidemiological studies actually supported this possibility (Viganò et al., 2015: Leone Roberti Maggiore et al., 2016).”
BackgroundResultInfluentialLier, M. C. I., Malik, R. F., Ket, J. C. F., Lambalk, C. B., Brosens, I. A., & Mijatovic, V. (2017) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2017.10.012 · Cited by 97 · see citing works
Bruun, M. R., Arendt, L. H., Forman, A., & Ramlau‐Hansen, C. H. (2018) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.13364 · Cited by 80 · see citing works
“It has been suggested that both endometriosis and adenomyosis could be associated with obstetrical complications (8), and speculation on whether adenomyosis poses a larger threat to the pregnancy exist.”
BackgroundBurghaus, S., Schäfer, S. D., Beckmann, M. W., Brandes, I., Brünahl, C., Chvatal, R., Drahoňovský, J., Dudek, W., Ebert, A. D., Fahlbusch, C., et al. (2021) · Geburtshilfe und Frauenheilkunde · doi:10.1055/a-1380-3693 · Cited by 69 · see citing works
“3 Endometriose: Schwangerschaft und Geburt Bezüglich der Schwangerschaft existiert inzwischen eine größere Anzahl an Studien, die eine erhöhte Risikokonstellation wie folgt darstellt: ▪ Abortrate [28] ▪ Frühgeburtlichkeit [29] ▪ vorzeitiger Blasensprung [30] ▪ vorzeitige Plazentalösung [31] ▪ Placenta praevia [31] ▪ P…”
BackgroundEffect of aromatherapy on post-partum complications: A systematic review
Keikhaie, K. R., Hastings‐Tolsma, M., Bouya, S., Shad, F. S., Sari, M., Shoorvazi, M., Younes-Barani, Z., & Balouchi, A. (2019) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2019.03.010 · Cited by 65 · see citing works
Villette, C., Bourret, A., Santulli, P., Gayet, V., Chapron, C., & de Ziegler, D. (2016) · Fertility and Sterility · doi:10.1016/j.fertnstert.2016.04.014 · Cited by 59 · see citing works
Endometriosis, especially mild disease: a risk factor for miscarriages
Kohl Schwartz, A. S., Wölfler, M. M., Mitter, V., Rauchfuss, M., Haeberlin, F., Eberhard, M., von Orelli, S., Imthurn, B., Imesch, P., Fink, D., et al. (2017) · Fertility and Sterility · doi:10.1016/j.fertnstert.2017.08.025 · Cited by 63 · see citing works
“It has been shown that phenotypic classification corresponds better to the 246 obstetric outcome than the rASRM classification (42,43).”
A Relationship Between Endometriosis and Obstetric Complications
Kobayashi, H., Kawahara, N., Ogawa, K., & Yoshimoto, C. (2020) · Reproductive Sciences · doi:10.1007/s43032-019-00118-0 · Cited by 57 · see citing works
“Endometriosis significantly increased the incidence of preterm birth [6–12, 24–27, 31–36], miscarriage [13, 34], preterm premature rupture of membranes [8, 10, 32], placenta previa [7, 9, 11, 14, 32, 34, 35], preeclampsia [7, 10, 27, 32, 36], pregnancy-induced hypertension (PIH) [6, 7, 31, 32], gestational diabetes [8…”
BackgroundObstetrical complications of endometriosis, particularly deep endometriosis
Leone Roberti Maggiore, U., Inversetti, A., Schimberni, M., Viganò, P., Giorgione, V., & Candiani, M. (2017) · Fertility and Sterility · doi:10.1016/j.fertnstert.2017.10.035 · Cited by 60 · see citing works
Endometriosis and Pregnancy: A Single Institution Experience
Porpora, M. G., Tomao, F., Ticino, A., Piacenti, I., Scaramuzzino, S., Simonetti, S., Imperiale, L., Sangiuliano, C., Masciullo, L., Manganaro, L., et al. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17020401 · Cited by 47 · see citing works
“Complications of preexisting endometriotic foci during pregnancy are rare [46]; in our study, we observed one case of hemoperitoneum due to probable rupture of an ovarian endometrioma in the third trimester of pregnancy.”
BackgroundRiemma, G., FRANCISCIS, P. D., Verde, M. L., Ravo, M., Fumiento, P., Fasulo, D. D., Corte, L. D., Ronsini, C., Torella, M., & Cobellis, L. (2022) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.14621 · Cited by 43 · see citing works
Vercellini, P. (2015) · Fertility and Sterility · doi:10.1016/j.fertnstert.2015.09.004 · Cited by 40 · see citing works
Maternal and neonatal outcomes in women with colorectal endometriosis
Thomin, A., Belghiti, J., David, C., Marty, O., Bornes, M., Ballester, M., Roman, H., & Daraï, E. (2018) · BJOG: An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.14221 · Cited by 39 · see citing works
Impact of endometriosis on obstetric outcome after natural conception: a multicenter Italian study
Berlanda, N., Alio, W., Angioni, S. L., Bergamini, V., Bonin, C., Boracchi, P., Candiani, M., Centini, G., D’Alterio, M. N., Forno, S. D., et al. (2021) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-021-06243-z · Cited by 35 · see citing works
Epidemiology of subtle, typical, cystic, and deep endometriosis: a systematic review
Koninckx, P. R., Ussia, A., Keckstein, J., Wattiez, A., & Adamyan, L. (2016) · Gynecological Surgery · doi:10.1007/s10397-016-0970-4 · Cited by 30 · see citing works
Obstetrical complications and outcome in patients with endometriosis
Borisova, A. V., Konnon, S. R., Tosto, V., Gerli, S., & Radzinsky, V. E. (2020) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2020.1793326 · Cited by 32 · see citing works
Shi, J., Dai, Y., Zhang, J., Li, X., Jia, S., & Leng, J. (2021) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-021-03851-0 · Cited by 30 · see citing works
“Two other systematic reviews failed to draw conclusions on obstetrical complications related to EM except for preterm delivery [34] and placenta previa [35].”
BackgroundKobayashi, H., Yoshimoto, C., Matsubara, S., Shigetomi, H., & Imanaka, S. (2023) · Diagnostics · doi:10.3390/diagnostics13111926 · Cited by 36 · see citing works
“Collectively, the high iron content of ovarian endometriomas adversely affects the adjacent granulosa cells through oxidative stress by free iron-mediated Fenton reactions, reducing the quantity and quality of the retrieved oocytes [28,54,63], which could be associated with impaired fertility and adverse pregnancy out…”
BackgroundObstetrical and neonatal outcomes of pregnancies complicated by endometriosis
Shmueli, A., Salman, L., Hiersch, L., Ashwal, E., Hadar, E., Wiznitzer, A., Yogev, Y., & Aviram, A. (2017) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2017.1393513 · Cited by 29 · see citing works
“Other neonatal complications were observed in several studies, including low birthweight, prematurity and stillbirth [16], however, these were not observed in our cohort.”
ResultSalmeri, N., Piani, L. L., Cavoretto, P. I., Somigliana, E., Viganò, P., & Candiani, M. (2023) · Scientific Reports · doi:10.1038/s41598-023-35236-y · Cited by 29 · see citing works
Salmeri, N., Farina, A., Candiani, M., Dolci, C., Bonavina, G., Poziello, C., Viganò, P., & Cavoretto, P. I. (2022) · Diagnostics · doi:10.3390/diagnostics12051024 · Cited by 30 · see citing works
Palomba, S., Santagni, S., Gibbins, K. J., Sala, G. B. L., & Silver, R. M. (2016) · Reproductive BioMedicine Online · doi:10.1016/j.rbmo.2016.08.007 · Cited by 30 · see citing works
The mid-secretory endometrial transcriptomic landscape in endometriosis: a meta-analysis
Vargas, E., García-Moreno, E., Aghajanova, L., Salumets, A., Horcajadas, J. A., Esteban, F. J., & Altmäe, S. (2022) · Human Reproduction Open · doi:10.1093/hropen/hoac016 · Cited by 27 · see citing works
“…involving inflammation, immune modulation, aberrant angiogenesis, oxidative stress, extracellular matrix remodelling, genetic and epigenetic changes could impact endometrial receptivity and implantation process in women with endometriosis (Gupta et al., 2008; Kokcu, 2013; Vigano et al., 2015).”
BackgroundRisk of miscarriage in women with endometriosis: insights from in vitro fertilization cycles
Leonardi, M., Papaleo, E., Reschini, M., Pagliardini, L., Benaglia, L., Candotti, G., Viganò, P., Quaranta, L., Munaretto, M., Candiani, M., et al. (2016) · Fertility and Sterility · doi:10.1016/j.fertnstert.2016.03.047 · Cited by 24 · see citing works
“Recently, interest on this argument has re-flourished (8,9) but, to date, definite conclusions cannot be drawn because the designs of the available studies are generally weak and results inevitably exposed to confounders (Table 1) (10-16).”
BackgroundWang, H., Tsai, C.-L., Chang, P.-Y., Chao, A., Wu, R., Chen, S., Wang, C., Yen, C., Lee, Y., & Wang, T. (2018) · PLoS ONE · doi:10.1371/journal.pone.0190573 · Cited by 22 · see citing works
Carneiro, M. M., Costa, L. M. P., & Ávila, I. D. (2017) · JBRA Assisted Reproduction · doi:10.5935/1518-0557.20170027 · Cited by 21 · see citing works
“…addition, some studies suggest that the presence of endometriosis per se may adversely affect pregnancy and neonatal outcomes (Brosens et al., 2012; Vigano et al., 2015; Jacques et al., 2016), while a recent systematic review stated that complications of endometriosis during pregnancy were rare…”
BackgroundKim, S.-G., Seo, H.-G., & Kim, Y. (2017) · Obstetrics & Gynecology Science · doi:10.5468/ogs.2017.60.3.283 · Cited by 21 · see citing works
Vercellini, P., Viganò, P., Frattaruolo, M. P., Borghi, A., & Somigliana, E. (2018) · Human Reproduction · doi:10.1093/humrep/dey104 · Cited by 20 · see citing works
“In any case, the association seems to be with deep endometriosis in general and not specifically with colorectal endometriosis (Vigano et al., 2015; Leone Roberti Maggiore et al., 2017; Zullo et al., 2017).”
BackgroundGuo, H., Gao, H., Li, J., Cong, Y., Chen, Q., Wang, Y., Zhu, Q., Lyu, Q., Wu, L., Chai, W., et al. (2020) · Annals of Translational Medicine · doi:10.21037/atm.2020.02.15 · Cited by 19 · see citing works
“The expansion of results from most previous studies is limited by the methodology, sample size and accurate diagnosis (28,29).”
ResultGebremedhin, A. T., Mitter, V. R., Duko, B., Tessema, G. A., & Pereira, G. F. (2023) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-023-07002-y · Cited by 19 · see citing works
“MAR treatment itself has shown to be a risk factor for adverse pregnancy outcomes, with mixed results for women with endometriosis [47].”
BackgroundResultMaternal–Fetal Outcomes in Women with Endometriosis and Shared Pathogenic Mechanisms
Frîncu, F., Carp-Velișcu, A., Petca, A., Badiu, D., Brătilă, E., Cîrstoiu, M., & Mehedințu, C. (2021) · Medicina · doi:10.3390/medicina57111258 · Cited by 17 · see citing works
Effects of adenomyosis on obstetric outcomes
Cozzolino, M., Basile, F., & Pontrelli, G. (2019) · Minerva Obstetrics and Gynecology · doi:10.23736/s0026-4784.18.04318-6 · Cited by 17 · see citing works
Adenomyosis: Disease, uterine aging process leading to symptoms, or both?
Πρωτόπαπας, Α., Grimbizis, G., Athanasiou, S., & Loutradis, D. (2020) · PubMed Central · Cited by 17 · see citing works
Endometriosis-related spontaneous hemoperitoneum in the early second trimester: A case report
Huang, L.-Y., Hsu, P.-Y., Chiang, C.-T., Chen, H., & Wu, M. (2021) · Taiwanese Journal of Obstetrics and Gynecology · doi:10.1016/j.tjog.2021.01.032 · Cited by 17 · see citing works
Delivery after Operation for Deeply Infiltrating Endometriosis
Allerstorfer, C., Oppelt, P., Enzelsberger, S., Shamiyeh, A., Schimetta, W., Shebl, O. J., & Mayer, R. B. (2016) · BioMed Research International · doi:10.1155/2016/8271452 · Cited by 16 · see citing works
“Previous studies have shown that deeply infiltrating endometriosis can be associated with a various number of complications during pregnancy and delivery [6].”
BackgroundInfluentialEndometriosis-associated Maternal Pregnancy Complications – Case Report and Literature Review
Petresin, J., Wolf, J., EMİR, S. N., Müller, A., & Boosz, A. S. (2016) · Geburtshilfe und Frauenheilkunde · doi:10.1055/s-0042-101026 · Cited by 15 · see citing works
Jin, Z., Wu, X., Liu, H., & Xu, C. (2020) · Experimental and Therapeutic Medicine · doi:10.3892/etm.2020.8580 · Cited by 15 · see citing works
“Similar to endometriosis, adenomyosis is closely associated with inflammation and angiogenesis (8,9), to which the prostaglandin cascade initiated by cyclooxygenases (COXs) may serve an important role.”
Uterine Artery Pseudoaneurysm in a Pregnant Patient with Retrocervical Endometriosis
Zilberman, A., Eisenberg, V. H., Yoeli, R., Soriano, D., Sivan, E., Golan, G., & Mashiach, R. (2020) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2020.03.010 · Cited by 15 · see citing works
Han, X., Gao, X., Wang, F., Shang, C., Liu, Z., & Guo, H. (2023) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.14650 · Cited by 13 · see citing works
Bulun, S. E. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-47912-7.00025-1 · Cited by 13 · see citing works
Novel TRERF1 mutations in Chinese patients with ovarian endometriosis
Cao, B., Zeng, Y., Wu, F., Liu, J., Shuang, Z., Xu, X., & Guo, J.-B. (2018) · Molecular Medicine Reports · doi:10.3892/mmr.2018.8510 · Cited by 13 · see citing works
Han, Y., Liu, C., Liu, D., Wu, L., & Huang, W. M. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1507252 · Cited by 12 · see citing works
“These factors potentially interfere with folliculogenesis, sperm function, embryo transport, and endometrial receptivity (4, 5).”
Ribot, É., Berbis, J., Hamouda, I., Cohen, D. T., Agostini, A., & Courbière, B. (2021) · Journal of Gynecology Obstetrics and Human Reproduction · doi:10.1016/j.jogoh.2021.102274 · Cited by 12 · see citing works
Spontaneous Hemoperitoneum in Pregnancy and Endometriosis: A New Challenge in a Known Disease
Sharon, N. Z., Shiber, Y., Vaknin, Z., Betser, M., Copel, L., & Maymon, R. (2023) · Obstetrical & Gynecological Survey · doi:10.1097/ogx.0000000000001107 · Cited by 12 · see citing works
“Previous case reports and reviews have reported a favorable outcome when a close follow-up was maintained.(9,11,18,27,28) Repeated assessments of hemoglobin level, vital signs, and sonography are helpful in the early identification and prevention of deterioration.”
ResultYang, B., Wang, L., Wan, X., Li, Y., Yu, X., Qin, Y., Luo, Y., Wang, F., & Huang, O. (2017) · BMC Women s Health · doi:10.1186/s12905-017-0474-z · Cited by 12 · see citing works
“A series of hypotheses that attempt to explain the genesis of adenomyosis has been established [3].”
BackgroundDeep Infiltrating Endometriosis and Adenomyosis: Implications on Pregnancy and Outcome
Gruber, T. M., Ortlieb, L., Henrich, W., & Mechsner, S. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm11010157 · Cited by 11 · see citing works
Impact of Adenomyosis on Infertile Patients—Therapy Options and Reproductive Outcomes
Günther, V., Allahqoli, L., Gitas, G., Maass, N., Tesch, K., Ackermann, J., Rosam, P., Mettler, L., von Otte, S., & Alkatout, İ. (2022) · Biomedicines · doi:10.3390/biomedicines10123245 · Cited by 10 · see citing works
“Furthermore, adenomyosis is associated with higher rates of obstetric complications, such as preterm birth and preterm rupture of the amniotic membranes [19,20].”
BackgroundGruber, T. M., Ortlieb, L., Henrich, W., & Mechsner, S. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13020414 · Cited by 9 · see citing works
Park, B. Y., Yao, R., Rossi, J., & Lee, A. W. (2023) · Fertility and Sterility · doi:10.1016/j.fertnstert.2023.03.033 · Cited by 8 · see citing works
Edelstein, S., Shachar, I. B., Ben-Amram, H., Biswas, S., & Marcus-Braun, N. (2019) · Infectious Diseases in Obstetrics and Gynecology · doi:10.1155/2019/4149587 · Cited by 8 · see citing works
Hemoperitoneum Following Sexual Intercourse in a Woman with Deep Infiltrating Endometriosis
Buggio, L., Aimi, G., & Vercellini, P. (2016) · Gynecologic and Obstetric Investigation · doi:10.1159/000447262 · Cited by 7 · see citing works
Li, Y., Ge, L., Yang, X., Cui, L., & Chen, Z. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1248274 · Cited by 6 · see citing works
Riemma, G., Cobellis, L., Laganà, A. S., Etrusco, A., Corte, L. D., Torella, M., Vastarella, M. G., Carotenuto, R. M., & FRANCISCIS, P. D. (2025) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.70134 · Cited by 7 · see citing works
“31 This network meta-analysis did not evaluate this issue as only one out of the nine included studies evaluated the co-presence of ade-nomyosis, without providing separate data.”
Adenomyosis and pregnant uterus: An alliance doomed to rupture?
Nohuz, E., Albaut, M., Bayeh, S., Tamburro, S., & Chene, G. (2019) · Journal of Gynecology Obstetrics and Human Reproduction · doi:10.1016/j.jogoh.2019.101632 · Cited by 5 · see citing works
Wang, Y., Hu, Z., Jiang, P., Kong, W., Gong, C., Chen, Y., Xu, L., Yang, Y., & Hu, Z. (2023) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-023-07136-z · Cited by 5 · see citing works
“…pregnancy-related complications (hypertensive disorder complicating pregnancy, PPROM, GDM, postpartum hemorrhage, etc.) was also much higher than that in the low-risk group, which undoubtedly increased the risk of adverse pregnancy outcomes on another level, thus entered a “vicious circle” [7, 27].”
Spontaneous hemoperitoneum in pregnancy due to endometriosis
Kim, T. G., Sudhof, L. S., Liu, F. W., & Shainker, S. A. (2020) · Journal of Endometriosis and Pelvic Pain Disorders · doi:10.1177/2284026520942432 · Cited by 5 · see citing works
Labor may mask a symptom of the rupture of ovarian endometrial cyst: a case report
Kino, T., Obata, S., Osanai, N., Hashimoto, A., Okada, Y., Aoki, S., & Miyagi, E. (2018) · Clinical Case Reports · doi:10.1002/ccr3.1554 · Cited by 4 · see citing works
“The clinical symptom of rupture of endometrial cyst is often lower abdominal pain without signs of infection [8].”
BackgroundAgrawala, S., Patil, J., Campbell, S. B., & Woodard, T. L. (2021) · Fertility Research and Practice · doi:10.1186/s40738-021-00097-4 · Cited by 4 · see citing works
Endometriosis and risk factors in pregnancy, labor and delivery: a case-control study
Alboni, C., Cannoletta, M., MOSCA, S., PASINI, S., Farulla, A., & Chiossi, G. (2024) · Minerva Obstetrics and Gynecology · doi:10.23736/s2724-606x.24.05527-1 · Cited by 3 · see citing works
A bélendometriosis miatt végzett műtétek hatása a fertilitásra
Brubel, R., Dobó, N., Csibi, N., Kövesdi, A., Máté, S., Ács, N., Lukovich, P., Murber, Á., & Bokor, A. (2019) · Orvosi Hetilap · doi:10.1556/650.2019.31514 · Cited by 3 · see citing works
Nomograms for predicting adverse obstetric outcome in IVF pregnancy: A preliminary study
Portal, A., Sunyach, C., Loundou, A., Paulmyer‐Lacroix, O., Perrin, J., & Courbière, B. (2021) · Birth · doi:10.1111/birt.12528 · Cited by 3 · see citing works
Gebremedhin, A. T., Mitter, V. R., Duko, B., Tessema, G. A., & Pereira, G. F. (2023) · Research Square · doi:10.21203/rs.3.rs-2462392/v1 · Cited by 3 · see citing works
A narrative review of endometriosis surgery and infertility
Çoban, U., Hatırnaz, Ş., & Kalkan, Ü. (2021) · Gynecology and Pelvic Medicine · doi:10.21037/gpm-20-55 · Cited by 2 · see citing works
“Endometriosis, and particularly DIE, is known risk factor for abnormal placental implantation (11).”
BackgroundFrom Endometriosis to Pregnancy: Which is the “Road-Map”?
Zupi, E., Felice, G. D., Conway, F., Martire, F. G., Exacoustós, C., Centini, G., Patrizi, L., Piccione, E., & Lazzeri, L. (2017) · Journal of Endometriosis and Pelvic Pain Disorders · doi:10.5301/jeppd.5000307 · Cited by 2 · see citing works
“In a review conducted by Viganò et al (90) the prevalence of spontaneous bowel perforations remained unknown.”
BackgroundMethodInfluentialGürgan, T., & Bektaş, G. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-89907-9.00014-4 · Cited by 2 · see citing works
Hemoperitoneu Espontâneo na Gravidez
Gonçalves, D. R., Teixeira, M., Rodrigues, R., & Braga, J. S. (2019) · Acta Médica Portuguesa · doi:10.20344/amp.11169 · Cited by 2 · see citing works
Rare and acute complications of endometriosis in pregnant women
Николаевна, В. Е., Артымук, Н. В., & Zotova, O. A. (2021) · Fundamental and Clinical Medicine · doi:10.23946/2500-0764-2021-6-1-69-76 · Cited by 2 · see citing works
“(2015), показал, что общая распространенность спонтанного гемоперитонеума, связанного с эндометриозом, у беременных составляет около 0,4%, риск его повышен у женщин с эндометриозом в случае зачатия с помощью ЭКО [34].”
Ovsyannikova, M. R., Popov, А. А., Chantieva, T. M., & Shidlovskaya, N. V. (2023) · Russian Bulletin of Obstetrician-Gynecologist · doi:10.17116/rosakush2023230419 · Cited by 1 · see citing works
Impact of adenomyosis on fertility and obstetric outcomes among women in tertiary care center
Hoque, L. F., Begum, F., Apsara, S., & Zinan, A. Z. (2025) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20250173 · Cited by 1 · see citing works
Harigane, E., Matsushima, T., Watanabe, A., Shinmura, H., Kurashina, R., Shigemi, D., & Suzuki, S. (2025) · Journal of Nippon Medical School · doi:10.1272/jnms.jnms.2025_92-106 · Cited by 1 · see citing works
“Many recent reports have shown a relationship between endometriosis and perinatal complications 1 ― 5 .”
Keß, S., & Germeyer, A. (2023) · Die Gynäkologie · doi:10.1007/s00129-023-05065-1 · Cited by 1 · see citing works
Nkobetchou, M., Cohen, Y., Bonhomme, S., Dallongeville, A., & Azria, É. (2021) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2021.09.005 · Cited by 1 · see citing works
Kinderwunsch und Schwangerschaft bei Endometriose
Shebl, O. J., Ebner, T., & Oppelt, P. (2016) · Gynäkologische Endokrinologie · doi:10.1007/s10304-015-0052-0
L’endométriose, une maladie encore méconnue
Linet, T. (2018) · Vocation Sage-femme · doi:10.1016/j.vsf.2018.05.003
Usefulness of plasma D-dimer levels in detecting ruptured ovarian endometrioma
Kajimura, I., Fujishita, A., Fukushima, A., Matsumoto, K., Yoshitake, T., & Hiraki, K. (2018) · JAPANESE JOURNAL OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY · doi:10.5180/jsgoe.34.1_86
Reproductive disorders and obstetric complications in gynecological diseases
Унанян, А. Л., Is, S., Никонец, А. Д., Аминова, Л. Н., Алимов, В. А., Викторовна, Щ. А., Chushkov, Y. V., & Baburin, D. V. (2018) · GYNECOLOGY · doi:10.26442/2079-5696_2018.2.77-81
Hemoperitoneo postcoital secundario a desgarro mesentérico sin lesión vaginal asociada
Reyna‐Villasmil, E., & Torres-Cepeda, D. (2018) · Avances en Biomédicina
Belaroussi, I., Zanini, A.-S., & Azria, É. (2020) · Elsevier eBooks · doi:10.1016/b978-2-294-76781-4.00017-x
A case of spontaneous bowel perforation in labour secondary to endometriosis
Draper, H., Cunningham, K., Muthukumarasamy, S., & Phillips, K. (2021) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443615.2020.1846167
“It is likely that they are under-reported in the literature and the true prevalence of spontaneous bowel perforation in pregnancy is unknown (Vigano et al. 2015).”
BackgroundDie Uterusruptur – eine lauernde Gefahr
Küpker, W., Agic, A., Diedrich, K., & Felberbaum, R. E. (2022) · Der Gynäkologe · doi:10.1007/s00129-022-04923-8
“Als mögliche Schwangerschafts- und Geburtskomplikationen sind hier das spontane Hämatoperitoneum, Ruptur von Endometriosezysten, Ruptur des Ureters, spontaneDarmperforationenundebendieUterusruptur zu nennen [14].”
BackgroundShi, J., Dai, Y., Zhang, J., Li, X., Jia, S., & Leng, J. (2020) · Research Square · doi:10.21203/rs.3.rs-85435/v1
Pregnancy and Obstetric Outcomes in Endometriosis
Oppelt, P., & Renner, S. P. (2022) · Springer eBooks · doi:10.1007/978-3-030-97236-3_18
Complicated Pelvic Inflammatory Disease
Augustin, G. (2023) · Springer eBooks · doi:10.1007/978-3-031-26021-6_13
Endometriosis-Related Complications in Women Undergoing In Vitro Fertilization
Riemma, G., Vitale, S. G., & Angioni, S. L. (2024) · Springer eBooks · doi:10.1007/978-3-031-50662-8_20
Libretti, A., Nicosia, A., Remorgida, V., & Leo, L. (2025) · Women · doi:10.3390/women5010001
Li, Z., Chen, W., Sun, X., Zhao, X., Hu, J., Ge, L., Wang, W., & Zhang, P. (2025) · Frontiers in Endocrinology · doi:10.3389/fendo.2025.1473923
Miyazaki, Y., Takada, S., Yamazaki, R., Hirabuki, S., & Sasaki, H. (2026) · Cureus · doi:10.7759/cureus.101871
“However, several studies have suggested an association between adhesions and ovarian endometrioma rupture [1,3,5].”
Uterine rupture during labor in a patient with endometriosis: A case report
Häusler, J., Studer, C., Bütikofer, K., & Stevanovic, N. (2026) · Case Reports in Women s Health · doi:10.1016/j.crwh.2026.e00789
Koroneos, Z., Cao, M., Mooney, S. S., Tyson, K., & Holdsworth‐Carson, S. J. (2026) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2026.115094 · Cited by 1 · see citing works
- Authors
- Vigano, P., Corti, L., & Berlanda, N.
- Affiliations
- IRCCS Ospedale San Raffaele (IT)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2015-10
- Volume
- 104
- Issue
- 4
- Pages
- 802-812
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2149590430
- Cited by
- 103
- References
- 85
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 3 · 2023: 15 · 2022: 7 · 2021: 14 · 2020: 10 · 2019: 8 · 2018: 11 · 2017: 12 · 2016: 11 · 2015: 1
- FWCI
- 1.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- INFM-OAR (INFN Catania) (submittedVersion, other-oa)
- Zenodo (CERN European Organization for Nuclear Research) (other-oa)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Keywords
- endometriosis, adenomyosis, pregnancy complications, spontaneous hemoperitoneum, uterine rupture, intestinal perforation, miscarriage, gestational diabetes mellitus, preeclampsia, preterm birth, placenta previa, placental abruption, cesarean section, neonatal outcomes, postpartum complications
- MeSH terms
- Endometriosis, Female, Hemoperitoneum, Humans, Infant, Newborn, Infertility, Ovarian Diseases, Peritoneal Diseases, Pregnancy, Pregnancy Complications, Puerperal Disorders, Postpartum Period, Adenomyosis
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