Are the pregnancies of women with endometriosis at greater risk of complications? Answers with Dr Érick Petit, radiologist, founder and head of the endometriosis center of the Paris-Saint-Joseph hospital group.
- Women suffering from endometriosis are not at greater risk than others of having complications during their pregnancy.
- “There is no intrauterine growth retardation. There is also no increase in premature birth,” insists the specialist.
- The doctor points out, however, that initially, there is an increased risk of ectopic pregnancy, alongside the risk of spontaneous miscarriage, but once again, these events remain relatively rare.
“There is not necessarily a greater risk of complications during pregnancy when you suffer from endometriosis.”, tells us Dr Érick Petit, also a member of the steering committee for the national strategy against endometriosis. “There may be some, but it is rare, it happens in less than 1% of cases.”
Pregnancy and endometriosis: “rare secondary phenomena”
“There is no intrauterine growth retardation. There is also no increase in premature birth, insists the specialist. It has been the sea serpent for a very long time, but a large study published in JAMA in February 2022, under the aegis of Louis Marcellin in Cochin-Port-Royal and in collaboration with our team in Saint-Joseph, shows quite the opposite. In more than 1,350 patients studied prospectively, no increased premature delivery was observed.”
“The rest are epiphenomena, that is to say that there are sometimes ruptures of endometriotic cysts, superinfections, spontaneous digestive perforations, or even hemoperitoneum, a phenomenon very difficult to explain of which we know nothing. the pathophysiology is not clear, but it is very rare, all these cases are very exceptional.”
The doctor points out, however, that initially, there is an increased risk of ectopic pregnancy, alongside the risk of spontaneous miscarriage, but once again, these events remain relatively rare. “So ultimately, phenomena secondary to endometriosis for pregnancy itself are rare enough to not necessarily justify increased monitoring of the patient.”
During pregnancy, endometriosis goes dormant
Who says pregnancy, necessarily says absence of menstruation. It is then said that endometriosis goes dormant. “Pregnancy is the ideal spontaneous natural treatmentsmiles the expert. For nine months, they are good! You should still know that in approximately 20% of cases, in the first trimester, there may be a painful rebound which can be explained by the hormonal environment which is not yet entirely optimal, particularly with the increase estrogen levels. Then afterwards, at the end of the first trimester, everything calms down, and so all the patients feel much better.”
Pregnancy therefore suspends the problem for nine months, and possibly afterwards, when women are breastfeeding. “As long as there is no return of the diaper, this continues, but as soon as the periods return, the process returns because endometriosis is a chronic inflammatory disease and does not stop until menopause… There is preconceived ideas on this, so I insist, pregnancy does not cure endometriosis, it simply suspends the disease.”
The full interview with Dr Érick Petit in Question aux Experts can be found on our YouTube channel: