22 feb. 2011 CONSECINTELE SARCINII ASUPRA ENDOMETRIOZEI : REVERSUL MEDALIEI PENTRU ENDOMETRIOZA SI COMPLICATIILE SARCINII
Natalia Darii Plopa*, Ivona Anghelache Lupascu **
*CHU Dinant Godinne, Departament Ginecologie-FIV, Yvoir, Belgia
**Maternitatea Cuza Voda,Clinica II Ostetrica-Ginecologie, Iasi, Romania
Rezumat
Consecintele endometriozei asupra procesului de decidualizare si placentatie sunt bine studiate si este cunoscut ca pacientele cu endometrioza au riscuri obstetricale mai mari decit populatia generala.
Sarcina la rindul ei poate influenta endometrioza, frecvent de maniera favorabila. Unele complicatii rare dar de o gravitate importanta cum ar fi perforatia intestinala din cadrul endometriozei profunde, hemoperitoneul spontan (SHiP) din endometrioza pelvina sau trasformarea neoplazica a unui endometriom pot insa apare in timpul sarcinii in contextul endometriozei. Cresterea endometriomului cu ruptura sau suprainfectia sa precum si evolutia leziunilor de endometrioza intestinala in timpul sarcinii sunt de asemenea posibile.
Toate aceste complicatii pot apare datorita unor leziuni de endometrioza care se comporta diferit in prezenta mediului hormonal de sarcina. Sensibilizarea clinicianului privitor aceste complicatii precum si identificarea pacientelor cu risc ar putea scadea morbiditatea si mortalitatea materno-fetala legata de acest tip de complicatii.
Abstract – The consequences of pregnancy on endometriosis: The downside for endometriosis and pregnancy complications
The consequences of endometriosis on decidualization process as well on placenta formation are well studied and is known that patients with endometriosis have higher risk of obstetrics complications than the general population.
The pregnancy may also influence the endometriosis but usually this influence is favorable with the regression of the disease. There are the rare but serious complications such as bowel perforation in deep endometriosis, the spontaneous hemoperitoneum in pregnancy (SHiP) in pelvic endometriosis or malignant transformation of ovarian endometrioma. Endometrioma growth with rupture or abcess transformation as well as bowel endometriotic lesion evolution may also be possible.
All these complications may occur due to different behavior of endometriotic lesions in the context of pregnancy. Clinician awareness regardind these complications and the identification of patients at risk could decrease morbidity and maternal and fetal mortality linked to this type of complications.
Keywords: endometriosis, pregnancy, obstetric complications