Aim. To review the current publication highlighting the features of pregnancy and childbirth outcomes in patients with endometriosis. Materials and methods. The analysis of 45 foreign and domestic publications on this topic has been carried out. Results. Patients with endometriosis have fertility problems, and when pregnancy occurs, it was characterized by a higher risk of preeclampsia, placenta previa, gestational diabetes, miscarriage and preterm labor, as well as delivery by caesarean section. Newborns in women with endometriosis have an increased risk of prematurity and small for gestational age. Probably, in addition to the presence of endometriosis, the risk of obstetric and neonatal complications is influenced by the localization and severity of the disease, as well as the use of assisted reproductive technologies. Conclusion. The results obtained indicate that patients with endometriosis have a high risk of perinatal complications and require additional antenatal monitoring and care.

Here we analysed rare and acute complications of endometriosis in pregnant women by searching Cochrane, HINARY, and PubMed databases. Keywords were “rare”, “causes”, “acute”, “complications”, “endometriosis”, and “pregnancy”. The search depth was 10 years (2011−2021). In total, we found 126 publications, 41 of which met the selection criteria. The course of pregnancy and childbirth in patients with endometriosis is insufficiently studied. Yet, it is characterised by a higher risk of complications including those rarely occurring: haemoperitoneum, intestinal perforation, appendicitis, torsion and rupture of the endometrioid cyst, and thoracic endometriosis. Because of major hormonal changes occurring during the pregnancy, endometriosis undergoes a significant progression or decidualisation. As endometrioid tissue is characterised by a resistance to progesterone, its defciency during the pregnancy can lead to necrosis, perforation of decidualised foci, and severe bleeding. Progesterone deficiency provokes hypervascularisation of the endometrioid tissue, which is the most common cause of spontaneous haemoperitoneum and most frequently occurs in the third trimester of pregnancy and after in vitro fertilisation. Pregnancy increases the risk of endometriosis-related intestinal perforation of different localisation: small intestine, caecum, appendix, and rectosigmoid colon. Limited information about the pregnancy-related complications of endometriosis leads to their underestimation, albeit they can be life-threatening and significantly impact the health of the mother and fetus. The results of this review indicate the need for the further studies of the pregnancy course in patients with endometriosis, especially after the use of assisted reproductive technology. Development of specific clinical guidelines would contribute to the efficient prevention of obstetric and perinatal complications in patients with endometriosis.

Aim. Evaluate the effectiveness of combined treatment and establish the frequency of recurrence of the ovarian endometrioma. Materials and methods. The prospective observational study evaluating the effectiveness of combined treatment of endometriomas, established the frequency of relapse after treatment. 186 patients with an established diagnosis of endometriosis of the ovaries were monitored, who underwent operative treatment in the volume of laparoscopic cystectomy. 95.0% of patients received anti-relapse hormonal treatment. Results. Against the background of treatment, positive dynamics were noted: dyspareunia, hyperspolymenorrhea and pre- and postmenstrual bloody discharge were stopped in 98.7% of cases, dysmenorrhea in 97.4% of cases, chronic pelvic pain in 94.8% cases. Pregnancy occurred in 11.7% of cases (1.3% of which when using assisted reproduction). The recurrence rate of endometriomas after 2 years was 1.4%, after 3 years 3.7%. Conclusion. Combination treatment was effective in reducing the severity or completely cured the symptoms of endometrioid ovarian cysts in 95% of women. The recurrence rate of endometriomas after 2 years was 1.4%, after 3 years 3.7%.

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