Publish 10 June 2021
Pregnancy is Complicated
In America, endometriosis affects more than 10% of the female population. Across the globe, greater than 175 million women are suffering from endometriosis. A woman with endometriosis can experience pain and difficulties with pregnancy. This requires ongoing medical care.
When a woman with endometriosis gets pregnant, there are more complications. In this regard, obstetrics and gynecology (ob-gyn) is invaluable. Let’s have a look at what endometriosis is and how it affects pregnancy.
The endometrium that lines the uterine walls grows outside the uterus, causing pain. Endometrial cells can grow into the pelvis.
As the menstrual cycle begins, endometrial cells grow, shrink, and bleed. These endometrial cells gradually develop within ovaries (release eggs), fallopian tubes (transport egg to uterus), and the pelvis. Subsequent irritation of these organs makes it difficult for a woman to conceive a child. 
Some women do not observe any endometriosis symptoms. But most experience the following :
- Frequent urination
- Irregular and painful periods
- Heavy menstrual bleeding
- Pelvic pain
- Painful copulation
How Endometriosis Affects Fertility
- Block the fallopian tube, thus affecting its function.
- Block the ovary, interfering with egg release.
According to research, the endometrial cells can cause severe inflammation during endometriosis. This inflammation severely affects estrogen and progesterone—important hormones during pregnancy. 
Effects of Endometriosis on Pregnancy
Normally, an ovary releases an egg that reaches the fallopian tube. When fertilized by a spermatozoon, it starts growing by attaching itself to uterine wall. During endometriosis, cyst-filled endometrial cells block the release of eggs.
These are ways endometriosis interferes with fertilization:
- Damage to the egg or sperm.
- Distortion of uterine cavity due to which, embryo does not implant.
- The immune system attacks the embryo.
- Inflammation influences the quality of eggs.
- Obstruction of fallopian tube. 
Endometriosis increases the chance of delivering premature babies. Sometimes, endometriosis improves during pregnancy. But it then causes complications during a future pregnancy.
Risks and Complications
- Miscarriage: Several studies report elevated miscarriage rates. One retrospective study found that women with endometriosis are more likely to experience miscarriage by 35.8 percent versus 22 percent in women without the condition. 
- Preterm Birth: A pregnant woman with endometriosis tends to give birth before 37 weeks of pregnancy by 1.7 times more than other expectant mothers. When an infant is born before 37 weeks of gestation, it is considered preterm. 
Prematurely born infants have a low birth weight and are more likely to encounter health and developmental issues. Preterm birth or early labor signs include:
- Periodic Contractions: Tightening of uterine muscles may cause midsection pain.
- Modification of Vaginal Discharge: Vaginal mucus viscosity can change or become bloody.
- Pelvis strain
- Placenta Previa: Your uterus produces placenta during pregnancy. This is the structure that supplies your developing fetus with oxygen and nourishment. Normally, it binds to the top of uterus. Placenta previa occurs when the placenta at the opening of the cervix binds to the bottom of the uterus.
⚠️ See your ob-gyn if you are having any of these symptoms. If birth is imminent, a doctor may prescribe medications to delay labor or improve the growth of your infant.
Placenta previa increases risk of ruptured placenta during childbirth. A ruptured placenta can lead to serious bleeding, putting you and your baby at risk.
Endometriosis may elevate risk for placenta previa. Bright red vaginal bleeding is the major symptom. With minor bleeding, doctors may advise you to restrict your habits, including sex and exercise. You might receive a recommendation of blood transfusion and emergency C-section in cases of serious bleeding. 
Doctors do not recommend that pregnant women receive the standard therapies for endometriosis, which are surgery and hormone therapy.
Over-the-counter pain relievers can help decrease the discomfort of endometriosis. Ask your ob-gyn doctor for a recommendation of how long you can use which ones safely. Hormone therapy and laparoscopic surgery is also useful.  Self-help steps include:
- Take hot baths.
- Consume foods high in fiber to reduce the chance of constipation.
- Walk slowly or practice prenatal yoga to alleviate back pain associated with endometriosis.
Receive an early diagnosis and treatment plan for endometriosis from your ob-gyn physician. This will help you better plan for pregnancy.
To support the writing of useful articles about ob-gyn, ClinicalPosters sells human anatomy posters, scientific posters and other products online. You may sponsor specific articles, remit a small donation,Slide extra posters into DeuPair Frames without removing from the wallYou can donateYou may sponsor specific articles, remit a small donation,Slide extra posters into DeuPair Frames without removing from the wallYou may remit a small donationAlso shop for ClinicalPins that include more than lapel pins or leave an encouraging comment to keep the work going. Stay safe and A Bit More Healthy.
- Leone Roberti Maggiore U, Ferrero S, Mangili G, Bergamini A, Inversetti A, Giorgione V, et al. A systematic review on endometriosis during pregnancy: diagnosis, misdiagnosis, complications and outcomes. Hum Reprod Update. 2016;22:70–103. doi:10.1093/humupd/dmv045.
- Leeners B, Damaso F, Ochsenbein-Kölble N, Farquhar C. The effect of pregnancy on endometriosis—facts or fiction? Hum Reprod Update. 2018;24:290–9. doi:10.1093/humupd/dmy004.
- Bulletti C, Coccia ME, Battistoni S, Borini A. Endometriosis and infertility. 2010:441–7. doi:10.1007/s10815-010-9436-1.
- Mizumoto Y, Furuy K, Kikuchi Y, Aida S, Hyakutake K, Tamai S, et al. Spontaneous rupture of the uterine vessels in a pregnancy complicated by endometriosis. Acta Obstet Gynecol Scand. 1996;75:860–2. doi:10.3109/00016349609054718.
- Zullo F, Spagnolo E, Saccone G, Acunzo M, Xodo S, Ceccaroni M, et al. Endometriosis and obstetrics complications: a systematic review and meta-analysis. Fertil Steril. 2017;108:667-672.e5. doi:10.1016/j.fertnstert.2017.07.019.
- Leone Roberti Maggiore U, Inversetti A, Schimberni M, Viganò P, Giorgione V, Candiani M. Obstetrical complications of endometriosis, particularly deep endometriosis. Fertil Steril. 2017;108:895–912. doi:0.1016/j.fertnstert.2017.10.035.
- Crane JMG, Van den Hof MC, Dodds L, Armson BA, Liston R. Neonatal outcomes with placenta previa. Obstet Gynecol. 1999;93:541–4. doi:10.1016/S0029-7844(98)00480-3.
- Moghissi KS. Medical treatment of endometriosis. Clin Obstet Gynecol. 1999 Sep;42(3):620-32. doi:10.1097/00003081-199909000-00016. PMID: 10451774.
Access more article features and references.