AFJOG

REVIEW advanced endometriosis will require either surgery or assisted reproduction technology to conceive. Obstetric complications of endometriosis Pregnant patients diagnosed with endometriosis should regarded as high risk and should preferably be referred to a tertiary Centre. Available evidence has shown that endometriosis was an independent risk factor for preterm birth, miscarriages, placenta praevia, small for gestational age and caesarean delivery. 12 Bo Y. Park et al showed that women with pregnancies complicated by endometriosis were 2.4 times more likely to develop severe maternal morbidity than those who did not have endometriosis. These patients had a higher risk of developing disseminated intravascular coagulation (aOR, 2.46; 95% CI, 1.65 – 3.66), heart failure (aOR, 2.58; 95% CI, 1.69 – 3.94), pulmonary oedema (aOR 3.02; 95% CI, 1.11 – 8.17), blood transfusion (aOR, 2.17; 95% CI, 1.75 – 2.68) and hysterectomy (aOR 2.46; 95% CI, 1.58 – 3.85). These risks of severe maternal morbidity were higher with vaginal delivery than caesarean delivery. 13 Deep invasive endometriosis is a risk factor for spontaneous haemoperitoneum during pregnancy and is associated with surgical complications during caesarean delivery. 14 CONCLUSION Endometriosis is a common but frequently misdiagnosed condition that has a negative impact on the quality of life of patients. Early diagnosis and treatment will prevent the various neurological sequelae such as peripheral sensitization, central sensitization and cross sensitization which are very difficult to manage. Adolescent girls with dysmenorrhea that affect their schooling, should be given medical treatment for endometriosis without laparoscopic confirmation. After conceiving, patients with endometriosis should be referred to, and managed at a high-risk Obstetrics unit as they are prone to develop severe morbidity. REFERENCES 1. Chapron C, Marcellin L, Borghese B and Santulli P. § ¡ ¢ § £ § £ £ ¡« § ¬ £ ¡ § £ £ ¢ ¬ £ £ £ £ £ African Journal of Obstetrics and Gynaecology | Volume 1 | Issue 1 | 2023 | 13