Endometriosis in pregnant and non-pregnant women at tubal sterilization.

ABSTRACT

PIP: Between 1986-1989, physicians compared endometriosis in 101 pregnant patients (12 weeks) and 107 nonpregnant patients at the University Hospital in Trondheim, Norway both of whom had undergone laparoscopic tubal sterilizations (bipolar coagulation) to determine prevalence of endometriosis in women undergoing sterilization. They also wanted to assess possible predisposing risk factors to endometriosis. The pregnant women underwent dilation and curettage concurrently with sterilization. Even though a higher percentage of the nonpregnant women (22%) had endometriosis than the pregnant women (16%), the difference was not significant. 1 pregnant case even had severe endometriosis. Significant histological differences between pregnant and nonpregnant women existed, however. Clear or red gland like peritoneal nonfibrotic, nonpigmented endometriotic lesions and no pockets characterized the endometriosis in 44% of the pregnant women indicating an early stage of endometriosis while such features occurred in just 4% of nonpregnant women (p.01). Further no decidual reaction was evident in 23% of the endometriotic lesions of pregnant women. 75% of nonpregnant women had brown, blue, or black pigmented lesions indicating an advanced stage of endometriosis while only 31% of pregnant women did (p.02). Nonpregnant women also were more likely to have fibrosis, yet the difference was not statistically significant. Even though women with endometriosis tended to have a retroverted uterus (31% vs. 14%) and the intervals of uninterrupted menstrual cycles were longer than those without endometriosis (106 vs. 87.8 months), the differences were insignificant. In conclusion, endometriosis is relatively common in women undergoing sterilization and in women in early pregnancy. The doctors did not find risk factors for endometriosis.