Obstetric complications after laparoscopic excision of posterior deep infiltrating endometriosis: A case-control study
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Objective To study obstetric outcomes and complications in women with previously excised posterior deep infiltrating endometriosis (DIE) in comparison with women without endometriosis.Design Matched case-control study.Setting Tertiary-level academic center.Patient(s) All surgeries for endometriosis performed in the Department of Gynecology and Gynecological Oncology, University of Bern between March 2004 and July 2015, were assessed. Inclusion criteria included complete laparoscopic excision of posterior DIE. Exclusion criteria included concomitant hysterectomies, refusal to participate, and patients lost to follow-up. Each subsequent pregnancy was matched to three controls by maternal age, parity, history of cesarean, and mode of conception.Intervention(s) None.Main outcome measure(s) Obstetric complications.Result(s) Among 841 patients with surgically diagnosed endometriosis, 125 satisfied the inclusion and exclusion criteria. Of these, 73 pregnancies resulted, although a further 11 patients were excluded owing to early miscarriages or extrauterine pregnancies. The final study cohort included 62 singleton pregnancies matched to 186 controls. The analysis identified an increased risk of placenta previa, gestational hypertension, and intrauterine growth restriction for the case group. The possibility of successful vaginal delivery was similar between groups. Moreover, no significant increase in risk of maternal and neonatal delivery complications, except for a slightly higher postpartum blood loss in the case group, was observed.Conclusion(s) Despite previous surgical excision, women with history of DIE present a higher risk of placenta previa, gestational hypertonia, and intrauterine growth restriction during pregnancy. Previous surgery for DIE does not seem to predispose to failed vaginal delivery.
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There is evidence that neonates born to mothers with AM are significantly lighter, more likely to be less than 2500 g and 1500 g, and to be below the 10th weight percentile compared to neonates of mothers without EM.
“There is evidence in the literature that neonates born to mothers with AM are significantly lighter, more likely to be less than 2500 g and 1500 g and to be below the 10th weight percentile compared to neonates of mothers without EM [18,19,27,34].”
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 [19]
Pregnancy problems do not improve after deep endometriosis excision.
“The latter is supported by the observation that pregnancy problems do not improve after deep endometriosis excision (256).”
From Pathogenesis of endometriosis: The genetic/epigenetic theory (2019) · cites this paper as [256]
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Lee, P., Zhou, C., & Li, Y. (2022) · Reproductive Biology and Endocrinology · doi:10.1186/s12958-022-00922-5 · Cited by 3 · 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
The Genetic-Epigenetic Pathophysiology of Endometriosis: A Surgeon’s View
Koninckx, P. R., Ussia, A., Adamyan, L. V., Keckstein, J., Wattiez, A., Gomel, V., & Martin, D. C. (2020) · Springer eBooks · doi:10.1007/978-3-030-52984-0_6 · Cited by 3 · see citing works
Zhu, L., Guan, Z., Huang, Y., Hua, K., Ma, L., Zhang, J., Yang, D., Perrot, V., Li, H., & Zhang, X. (2022) · Medicine · doi:10.1097/md.0000000000028766 · Cited by 3 · see citing works
Association between endometriosis and perinatal complications: a case-control study
Uchida, S., Fukuhara, R., Yokoyama, M., Akaishi, A., Iino, K., Yokota, M., & Yokoyama, Y. (2024) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-024-06724-4 · Cited by 3 · see citing works
Cystic Adenomyoma in Pregnancy: A Case Report
Verta, S., Brambs, C., & Christmann, C. (2024) · International Journal of Women s Health · doi:10.2147/ijwh.s450701 · Cited by 2 · see citing works
Nurindah, M., Winarto, H., Maidarti, M., Muharam, R., Harzif, A. K., Wiweko, B., Yanfaunnas, A. M., & Pratama, G. (2024) · Cureus · doi:10.7759/cureus.70668 · 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
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
Pregnancy and childbirth in patients with endometriosis
Bezhenar, V. F., Rogatinskaya, E. V., Dyachenko, D. T., & Fedosova, D. V. (2023) · Journal of obstetrics and women s diseases · doi:10.17816/jowd109303 · Cited by 1 · see citing works
Birth Register for Deep Endometriosis (BiRDeE): first analysis and recommendations
Enzelsberger, S., Oppelt, P., Schäfer, S. D., Denkmayr, D., Nanda, M., Edwards, C., Kolben, T., Kasparek, J., Bauer, B., Ruchay, Z., et al. (2024) · Journal of Endometriosis and Uterine Disorders · doi:10.1016/j.jeud.2024.100078 · Cited by 1 · see citing works
Endometriosis and adverse pregnancy outcomes: A case-control study
Shahmoradi, F., Haghighi, L., Noori, M., Derakhshan, R., Hashemi, N., & Rokhgireh, S. (2024) · International Journal of Reproductive BioMedicine (IJRM) · doi:10.18502/ijrm.v22i6.16798 · Cited by 1 · see citing works
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RetractedThe impact of endometriosis and adenomyosis on the female reproductive system
Nirgianakis, K. (2022) · doi:10.26481/dis.20220224kn
Self-citationRelações entre endometriose e a ocorrência de placenta prévia: uma revisão sistemática
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Pregnancy and Obstetric Outcomes in Endometriosis
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Fertility, Pregnancy Rate, and Neonatal Outcome of Patient with Adenomyosis
Adnyana, I. B. P., Udayana, I. G. N. B. S., Diningrat, M. A., & Setiawan, W. A. (2022) · European Journal of Medical and Health Sciences · doi:10.24018/ejmed.2022.4.5.1386
Endometriosis and Adverse Pregnancy Outcomes, controversies debatesPreprint
Shahmoradi, F., Haghighi, L., Noori, M., Derakhshan, R., Hashemi, N., & Rokhgireh, S. (2022) · Research Square · doi:10.21203/rs.3.rs-2290558/v1
Controversias en el tratamiento de la endometriosis en la mujer estéril
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Potential role of stem cells in the pathogenesis of endometriosis
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Compromised concept: Link between endometriosis, pregnancy complications and infertility
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Hurni, Y., Barbany‐Freixa, N., Manosalvas-Escobar, L., Castellví-Ibáñez, I., Pascual, M. A., García-Martínez, S., Prats, P., Cabrera, S., & Barri, P. N. (2026) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2026.06.006
- Authors
- Nirgianakis, K., Gasparri, M. L., Radan, A.-P., Villiger, A., McKinnon, B., Mosimann, B., Papadia, A., & Mueller, M. D.
- Affiliations
- University of Bern (CH)
- Corresponding author
- Nirgianakis, Konstantinos
- ORCID
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2018-08
- Volume
- 110
- Issue
- 3
- Pages
- 459-466
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2885646581
- Cited by
- 70
- References
- 38
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 11 · 2023: 7 · 2022: 14 · 2021: 10 · 2020: 13 · 2019: 4 · 2018: 2
- FWCI
- 7.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- BORIS (University Library Bern) (submittedVersion)
- 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
- deep infiltrating endometriosis, laparoscopic resection, pregnancy complications, placenta previa, gestational hypertension, fetal growth restriction, vaginal delivery, postpartum blood loss, pregnancy outcomes
- MeSH terms
- Adult, Endometriosis, Female, Humans, Obstetric Labor Complications, Laparoscopy, Pregnancy, Pregnancy Complications, Pregnancy Outcome, Case-Control Studies, Delivery, Obstetric
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