Skip to main content
SMFM 2024 Pregnancy Meeting Main banner
Final Program


Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared on social media
Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Poster Icons
Foundation Awardee
Foundation Awardee
No Social Media
No Social Media
Back
Q&A

Clinical Obstetrics

Poster Session 2

(370) Endometriosis complicated pregnancy: site-specific evaluation of characteristics and maternal morbidity

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Primary & Presenting Author(s)

  • Laurel S. Aberle, MD

    Los Angeles General Medical Center
    Los Angeles, CA, United States

    • Coauthor(s)

  • CV

    Caroline Violette, MD

    Los Angeles General Hospital + USC Medical Center
    Los Angeles, CA, United States

  • RM

    Rachel S. Mandelbaum, MD

    Los Angeles General Hospital + USC Medical Center
    Los Angeles, CA, United States

  • BS

    Bonnie Song, MD

    Los Angeles General Hospital + USC Medical Center
    Los Angeles, CA, United States

  • SM

    Shinya Matsuzaki, MD, PhD

    Division of Gynecologic Oncology, Department of Obstetrics and Gynecology
    Osaka International Cancer Institute
    Osaka, Osaka, Japan

  • JO

    Joseph G. Ouzounian, MBA, MD

    Professor and Chair of Obstetrics & Gynecology
    Los Angeles General Hospital + USC Medical Center
    Los Angeles, CA, United States

  • RP

    Richard Paulson, MD

    Los Angeles General Hospital + USC Medical Center
    Los Angeles, CA, United States

  • KM

    Koji Matsuo, MD, PhD

    Los Angeles General Hospital + USC Medical Center
    Los Angeles, CA, United States

Objective: To examine pregnancy characteristics and maternal morbidity at delivery among pregnant patients with a diagnosis of endometriosis.

Study Design: This cross-section study queried the National Inpatient Sample, examining 17,796,365 deliveries from 2016-2020. Exclusion criteria included adenomyosis and uterine myoma. Endometriosis location was grouped as adnexa, pelvic peritoneum, and other. The outcome measures were clinical and pregnancy characteristics and CDC-defined severe maternal morbidity and postpartum hemorrhage, assessed with multivariable model.

Results: Endometriosis was diagnosed in one in 1,012 patients (n=17,590), with 24.1% in the adnexa, 7.0% in the pelvic peritoneum, 5.5% in other locations, and 1.5% in multi-anatomical locations. In multivariable analysis, the prevalence of pregnancy complicated by endometriosis increased during the study period in both the adnexa and the pelvic peritoneum. The risk of placenta previa was increased in all endometriosis groups, especially in patients with pelvic peritoneal endometriosis (aOR 5.12, 95%CI 3.97-6.61). The risks of placenta accreta spectrum were increased with odds exceeding two-fold for locations other than adnexa and pelvic peritoneum (aOR 3.50, 95%CI 2.10-5.02) and multi-anatomical location endometriosis (aOR 2.87, 95%CI 1.10-7.50). All endometriosis-locations had increased risk for cesarean delivery, with multi-location endometriosis having the highest increase (aOR 42.62, 95%CI 24.91-72.92), followed by adnexal endometriosis (aOR 17.48, 95%CI 15.86-19.27). All endometriosis groups were associated with an increased risk of severe maternal morbidity at delivery, with pelvic peritoneal endometriosis having the highest risk (aOR 2.23, 95%CI 1.74-2.84), followed by adnexal endometriosis (aOR 1.97, 95%CI 1.72-2.25). The risk of postpartum hemorrhage was increased in multi-anatomical location endometriosis (aOR 1.97, 95%CI 1.26-3.09) and adnexal endometriosis (aOR 1.89, 95%CI 1.68-2.13).

Conclusion: Pregnancy complicated by endometriosis is associated with high-risk pregnancy characteristics and adverse delivery outcomes.