Prevalence of deep and ovarian endometriosis in early pregnancy: ultrasound diagnostic study. (5th January 2022)

• Record Type: Journal Article
• Authors: Bean, E.; Naftalin, J.; Horne, A.; Saridogan, E.; Cutner, A.; Jurkovic, D.
• Is Part Of: Ultrasound in obstetrics & gynecology. Volume 59:Number 1(2022)
• Page Start: 107
• Page End: 113
• Publication Date: 2022-01-05
• Subjects: decidualization -- endometriosis -- pregnancy -- prevalence -- ultrasonography; Ultrasonics in obstetrics -- Periodicals; Generative organs, Female -- Diseases -- Diagnosis -- Periodicals; Diagnosis, Ultrasonic -- Periodicals; Genital Diseases, Female -- ultrasonography -- Periodicals; Ultrasonography, Prenatal -- Periodicals; 618.047543
• DOI: 10.1002/uog.24756
• Languages: English
• ISSNs: 0960-7692

Abstract

ABSTRACT: Objective: To assess the prevalence and morphological appearance of deep endometriosis and ovarian endometrioma using pelvic ultrasound examination in women attending for an early pregnancy assessment. Methods: This was a prospective observational study set within a dedicated early pregnancy unit. The study included 1341 consecutive women who attended for an early pregnancy assessment for reassurance or because of suspected early pregnancy complications. All women underwent a transvaginal scan to assess the location and viability of their pregnancy. In addition, a detailed examination of pelvic organs was carried out to detect the presence of endometriosis and other gynecological abnormalities. Data analysis was performed using logistic regression and multivariable analysis. Results: The prevalence of deep endometriosis and/or ovarian endometrioma in women attending our early pregnancy unit was 4.9% (95% CI, 3.8–6.2%). In 33/66 (50.0% (95% CI, 37.9–62.1%)) women with endometriosis, this was a new diagnosis that was made during their early pregnancy scan. On multivariable analysis, the presence of endometriosis was strongly associated with a history of subfertility (odds ratio (OR), 3.15 (95% CI, 1.63–6.07)) and presence of a congenital uterine anomaly (OR, 5.69 (95% CI, 2.17–14.9)) and uterine fibroids (OR, 2.37 (95% CI, 1.31–4.28)). Morphological changes typical of decidualization were seen in 11/33 (33.3% (95% CI, 17.2–49.4%)) women with ovarian endometrioma and 18/57 (31.6% (95% CI, 19.5–43.7%)) women with deep endometriotic nodules. Conclusions: Deep endometriosis and ovarian endometrioma were present in a significant proportion of women attending for early pregnancy assessment. The prevalence varied depending on a history of subfertility, and therefore is likely to differ significantly among populations, depending on their characteristics. Ultrasound is a useful tool for the detection of endometriosis in early pregnancy and the identification of women who may benefit from specialist antenatal care. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.