The impact of adenomyosis on pregnancy outcomes was evaluated
Adenomyosis impairs the contractile function of the uterus during labor and pregnancy. The disease leads to an increased incidence of hypertensive disorders in pregnant women, low birth weight for gestational age, prolonged labor and placental retention. Gynecologists should be cautious when managing pregnant women with this diagnosis.Researchers from Ghent University, gynecologic hospitals and maternity hospitals in the Netherlands examined the prevalence of adverse obstetric and neonatal outcomes among women with histopathologically confirmed adenomyosis compared to the general population of women in the Netherlands. The results of the study are published in the American Journal of Obstetrics and Gynecology.
They analyzed 23 years of data on pregnancy outcomes in 7,925 women with histopathologically confirmed adenomyosis disease and compared it to the outcomes of more than 4.5 million women without the diagnosis.
Among women with adenomyosis, the authors found a 37% increased risk of hypertensive disorders and preeclampsia, a 15% increased risk of low birth weight for gestational age, and a 54% increased risk of emergency cesarean section. This group also had a 24% increased risk of prolonged labor, a 29% increased risk of placental retention, and a 23% increased risk of postpartum hemorrhage.
However, the authors found no increased risk of HELLP syndrome (hemolysis, increased liver enzymes and decreased platelet count), placental abruption, operative vaginal delivery or need for oxytocin stimulation in women with adenomyosis.
Researchers confirmed that adenomyosis increases the risk of hypertensive disorders in pregnant women, low birth weight for gestational age, and prolonged labor and placental retention. This indicates impaired uterine contractile function in labor and pregnancy in women with this condition. Therefore, the authors recommend that gynecologists and obstetricians exercise caution in the management of pregnant women with adenomyosis.