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. 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.
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Abdominal procedures for complicated colorectal endometriosis in the presence of a gravid uterus may be technically demanding and risky for both the mother and the fetus.
“Abdominal procedures for complicated colorectal endometriosis in presence of a gravid uterus may reveal technically demanding and risky for both the mother and the fetus (58,59).”
From Medical treatment in the management of deep endometriosis infiltrating the proximal rectum and sigmoid colon: a comprehensive literature review (2018) · cites this paper as [58]
CD in women with DIE is more difficult and associated with more complications than CD in women without EM.
“CD in women with DIE is more difficult and associated with more complications than CD in women without EM.”
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 [20]
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- Authors
- Thomin, A., Belghiti, J., David, C., Marty, O., Bornes, M., Ballester, M., Roman, H., & Daraï, E.
- Affiliations
- Assistance Publique – Hôpitaux de Paris (FR)
- Hôpital Charles-Nicolle (FR)
- Centre Hospitalier Universitaire de Rouen (FR)
- Department of Gynaecology and Obstetrics Hôpital Tenon Assistance Publique des Hôpitaux de Paris Université Pierre et Marie Curie Paris France
- ORCID
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2016-07-18
- Volume
- 125
- Issue
- 6
- Pages
- 711-718
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2497843218
- Cited by
- 39
- References
- 39
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 8 · 2023: 3 · 2022: 6 · 2021: 6 · 2020: 6 · 2019: 1 · 2018: 2 · 2017: 5
- FWCI
- 3.55
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- HAL (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 › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Keywords
- colorectal endometriosis, bowel endometriosis, deep infiltrating endometriosis, pregnancy outcomes, mode of delivery, cesarean section, vaginal delivery, postpartum complications, neonatal outcomes, endometriosis surgery
- MeSH terms
- Adult, Cesarean Section, Colonic Diseases, Endometriosis, Female, France, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Rectal Diseases, Retrospective Studies, Incidence, Treatment Outcome, Delivery, Obstetric, Postpartum Period
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