Endometriosis is a disease characterised by the presence of tissue resembling the lining of the uterus or endometrium, outside the uterus. In this article, we will know whether it makes pregnancies risky and if it increases the chance of a miscarriage.
How does endometriosis make pregnancy risky?
It is believed that endometriosis affects fertility in various ways. Not only does this condition make it hard to get pregnant, but it also makes the pregnancy difficult. Research states that there is a higher risk of placental previa [a complication where the placenta completely or partially covers the opening of the uterus (cervix)] in women who had surgical treatment for their endometriosis. The reason behind this might be due to the high severity of the disease in patients who had to undergo surgery. Therefore, it is advised that this potential increased risk should be looked into, and management for these patients should be done accordingly.
Another meta-analysis concluded that there is an increased risk of several adverse pregnancy outcomes with endometriosis. The adverse effects include various conditions, such as gestational hypertension (high blood pressure in pregnancy), pre-eclampsia (complication of pregnancy due to which the pregnant woman experiences high blood pressure and high protein levels in urine), preterm birth, placenta previa, placental abruption, cesarean section, and stillbirth. Other than these, severe complications of spontaneous bowel perforation may also be associated with endometriosis in pregnancy. However, extensive observational studies are needed to explore this further.
In conclusion, all the above-mentioned factors will increase the chances of risky pregnancies as well as miscarriages. However, another study published in 2016 gives a contradictory view and states that the complications of endometriosis during pregnancy are rare, and there is no evidence that the disease has a significant detrimental effect on pregnancy outcomes. Therefore, extensive observational studies are needed to explore this further.
Can endometriosis increase the risk of miscarriage?
A miscarriage is the loss of a baby or foetus before the 20th week of pregnancy. Endometriosis is considered to be a risk factor for miscarriage. Research states that among the wide range of complications that can generally occur during pregnancy, miscarriages account for 30–50% of all issues and are the most common complication associated with pregnancy. This study established that there is an increased rate of previous miscarriages associated with endometriosis. Another study states that there is an around 80% risk of miscarriage among endometriosis patients. This may be because of the inflammation and the structural changes as a result of endometriosis The condition causes alteration in the shape of the uterus, because of which embryo development becomes difficult.
Lastly, endometriosis can cause adhesions or scar tissues to disfigure the normal anatomy of the uterus, fallopian tubes and ovaries. Furthermore, if there is any damage to the tubes from endometriosis, it can also cause the fertilised egg to implant in the tube to cause ectopic pregnancy, eventually contributing to a high pregnancy risk.
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