Adenomyosis and obstetric complications: A retrospective case-control study

Area of Science:

• Reproductive Medicine
• Obstetrics and Gynecology
• Medical Imaging

Background:

• Adenomyosis is a common uterine condition affecting women of reproductive age.
• Diagnosis relies on histology or imaging like ultrasound and MRI.
• Previous studies on adenomyosis and obstetric complications used varied diagnostic criteria.

Purpose of the Study:

• To identify obstetric complications in women with adenomyosis using MRI-confirmed diagnoses.
• To assess the impact of adenomyosis on pregnancy outcomes.

Main Methods:

• Retrospective case-control study (January 2013 - December 2017).
• Inclusion of pregnant patients with MRI-confirmed adenomyosis.
• Matched controls (4:1 ratio) for age, parity, and BMI.
• Multivariate analysis to determine obstetric complication risks.

Main Results:

• Adenomyosis associated with increased risk of caesarean section (OR 1.1), intrauterine growth restriction (OR 1.3), postpartum haemorrhage (OR 1.2), pre-eclampsia (OR 1.3), and spontaneous miscarriage (OR 2.09).
• No significant increase in premature rupture of membranes, preterm delivery, severe intrauterine growth restriction, or placenta praevia.
• Study included 291 women with MRI-confirmed adenomyosis, with 89 achieving pregnancy.

Conclusions:

• Adenomyosis significantly increases the risk of several key obstetric complications.
• This is the first study to exclusively use MRI for adenomyosis diagnosis in this context.
• Further prospective studies are recommended for improved patient management during pregnancy.