Abstract

Endometriosis is a chronic gynecological condition characterized by the presence of endometrial-like tissue outside the uterine cavity, causing pelvic pain, dysmenorrhea, and infertility. While endometriosis is often associated with reproductive difficulties, pregnancy is still possible, though less frequent. The relationship between endometriosis and pregnancy presents unique challenges, as the condition may affect fertility, pregnancy outcomes, and maternal health. Endometriosis-related infertility can occur due to anatomical distortions, inflammation, and hormonal imbalances. Assisted reproductive technologies (ART) such as in vitro fertilization (IVF) have been used to improve conception rates in women with endometriosis. However, once pregnancy is achieved, endometriosis may lead to a range of complications, including increased risk of miscarriage, preterm birth, placental abnormalities, preeclampsia, and small for gestational age (SGA) infants. Pregnancy may alleviate some symptoms of endometriosis due to hormonal changes, but the disease can still progress in some women. Moreover, endometriomas (ovarian cysts associated with endometriosis) may increase in size or rupture during pregnancy, causing complications that may necessitate surgical intervention.

Management of endometriosis in pregnancy requires a multidisciplinary approach, involving obstetricians, gynecologists, and other specialists. Monitoring for pregnancy complications is crucial, and treatment decisions should be carefully weighed to balance the well-being of the mother and fetus. In cases of severe endometriosis, surgical intervention may be necessary, although this is typically avoided during pregnancy due to associated risks. Hormonal therapies used to treat endometriosis are generally contraindicated during pregnancy, requiring careful management of symptoms. Postpartum, symptoms of endometriosis often return, and long-term treatment plans should be discussed to manage the condition effectively.

Overall, endometriosis during pregnancy is associated with increased risks of complications, though pregnancy outcomes can be positive with appropriate management. Further research is needed to better understand the impact of endometriosis on pregnancy and to optimize treatment strategies for affected women.