Prevalence of deep and ovarian endometriosis in early pregnancy: ultrasound diagnostic study

Bean, E.; Naftalin, J.; Horne, Andrew; Sarıdoğan, Ertan; Cutner, Alfred

doi:10.1002/uog.24756

Cited by 14 publications

(23 citation statements)

References 25 publications

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“…However, no detailed information on locations of the lesions is available. A publication on 1341 pregnant women reported ultrasound‐based prevalence of endometriosis during early pregnancy being 4.9%, endometrioma being found in 2.5% and deep endometriosis in 4.3% of women 37 . Prevalence of endometriosis is much lower in this study than in ours and population selection and indication for ultrasound might explain the discrepancy.…”

Section: Discussioncontrasting

confidence: 84%

“…A publication on 1341 pregnant women reported ultrasound‐based prevalence of endometriosis during early pregnancy being 4.9%, endometrioma being found in 2.5% and deep endometriosis in 4.3% of women. 37 Prevalence of endometriosis is much lower in this study than in ours and population selection and indication for ultrasound might explain the discrepancy. Moreover, women with endometriosis might have lower pregnancy rates, therefore women who conceive would have lower prevalence of endometriosis.…”

Section: Discussioncontrasting

confidence: 81%

“…The younger population in our study compared with theirs might explain the difference, as adenomyosis has been shown to correlate with increasing age 8 . Lower prevalence of adenomyosis than in our study was reported in pregnant women during early pregnancy at ultrasound examination, 37 which could be explained by a possible adenomyosis effect on fertility. Adenomyosis has been shown to be associated with endometriosis 36 and deep endometriosis 8,38 .…”

Section: Discussioncontrasting

confidence: 64%

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Prevalence of endometriosis and adenomyosis at transvaginal ultrasound examination in symptomatic women

Orlov

Jokubkiene

2022

Acta Obstet Gynecol Scand

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Introduction Prevalence of endometriosis is commonly reported based on surgery findings and varies widely depending on study population and indication for surgery. Symptoms such as dysmenorrhea, pelvic pain, dyspareunia, dysuria, and dyschezia can be associated with endometriosis and adenomyosis. Transvaginal ultrasound examination is proposed to be the first‐line diagnostic method, nevertheless there are no published ultrasound‐based studies reporting prevalence of endometriosis and adenomyosis in symptomatic women other than those scheduled for surgery. The aim of this study was to determine the prevalence of endometriosis and adenomyosis as assessed by transvaginal ultrasound in women with symptoms suggestive of endometriosis and adenomyosis. Material and methods This is a retrospective cross‐sectional study performed at a tertiary‐care center including 373 symptomatic women who were systematically examined with transvaginal ultrasound by an experienced ultrasound examiner. Before ultrasound examination women filled in a questionnaire including self‐assessment of the severity of their symptoms (dysmenorrhea, chronic pelvic pain, dyspareunia, dysuria, dyschezia) using a visual analog scale. Abnormal findings in the uterus, ovaries, bowel, urinary bladder, uterosacral ligaments, and rectovaginal septum were noted, and their size and location were described. Prevalence of endometriosis, adenomyosis, endometrioma, and deep endometriosis in different anatomical locations was reported. Results Prevalence of ovarian endometrioma and/or deep endometriosis was 25% and of adenomyosis was 12%. Prevalence of endometrioma was 20% and of deep endometriosis was 9%, for each location being 8% in the bowel, 3% in the uterosacral ligaments, 3% in the rectovaginal septum and 0.5% in the urinary bladder. Conclusions In symptomatic women examined with transvaginal ultrasound by an experienced ultrasound examiner, ovarian endometrioma and/or deep endometriosis was found in one of four women and adenomyosis in one of nine women. Deep endometriosis was present in one of 11 women. Despite having symptoms, half of the women had no abnormal ultrasound findings.

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Section: Discussioncontrasting

confidence: 84%

Section: Discussioncontrasting

confidence: 81%

Section: Discussioncontrasting

confidence: 64%

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Prevalence of endometriosis and adenomyosis at transvaginal ultrasound examination in symptomatic women

Orlov

Jokubkiene

2022

Acta Obstet Gynecol Scand

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“…Our study is the first to analyze reproductive and gynecological outcomes with regard to the morphological subtype of the unicornuate uterus. Our diagnostic approach for detecting endometriosis and adenomyosis has been used in previous large‐scale prospective studies and has been shown to be effective and accurate 26 , 30 , 45 , 46 .…”

Section: Discussionmentioning

confidence: 99%

Reproductive outcome in 326 women with unicornuate uterus

Tellum

Bracco

Braud

et al. 2023

Ultrasound in Obstet & Gyne

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We found that a unicornuate uterus is associated with a lower live-birth rate and a higher risk of ectopic pregnancy, miscarriage, preterm delivery and malpresentation at birth in comparison to pregnancies in which the uterus is normally formed. Women with a unicornuate uterus were more likely to have adenomyosis and endometriosis, the risk of the latter being greatest in those with a functional rudimentary horn. What are the clinical implications of this work?These findings should inform the counseling of women with a unicornuate uterus. Removal of a functional rudimentary horn to prevent ectopic pregnancy should be discussed with the patient. Pregnant women with a unicornuate uterus have a higher risk of adverse outcome and warrant close monitoring.

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“…For diagnosis of OE, not only is ultrasonography a very effective and straightforward tool [ 13 ], CA-125 and CA19-9 levels have also been recommended as useful markers [ 14–16 ]. Ruptured OE is rare.…”

Section: Introductionmentioning

confidence: 99%

Extremely high serum CA19-9 level along with elevated D-dimer in assisting detection of ruptured ovarian endometriosis

et al. 2022

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Background To clarify clinical importance of serum CA19-9, CA-125, and plasma D-dimer (D-D) levels in detecting spontaneously ruptured ovarian endometriosis (OE). Materials and Methods We retrospectively examined 173 patients with endometriosis out of 735 cases of OE between 2013 and 2019. Among these, 21 cases were diagnosed as “spontaneously ruptured” after surgery, while the remaining cases were unruptured. Venous blood was collected pre-operatively to detect CA19-9, CA-125, and D-D levels. A receiver operating characteristic curve analysis was applied to test clinical value of each marker. Results Among the 21 patients with ruptured OE, 16 had a history of pelvic cysts, 19 claimed sudden onsets of lower abdominal pain, and fluid accumulation were detected in cul-de-sac in only six participants by ultrasound. For serological investigation, both CA19-9 and D-D were significantly elevated in the ruptured OE group (343.09 ± 367.67 U/ml vs. 36.84 ± 40.01 U/ml, 3.39 ± 4.90 mg/L vs. 0.43 ± 0.29 mg/L, both p < .0001). The area under curve (AUC) value for the combination of CA19-9 and D-D was 0.975 (95% CI, 0.939 − 0.993), with specificity of 96.69%, and sensitivity of 85.71%. The combination of CA-125, CA19-9 and D-D showed the highest AUC value that up to 0.976 (95% CI, 0.940–0.993), with sensitivity of 95.24%, and specificity of 87.50%. Conclusion The combination of CA19-9 and D-D can be chosen as an effective and economical indicators to identify patients with spontaneously ruptured OE in pre-operation assessment. However, from the perspective of differential diagnosis, the combination of CA-125, CA19-9 and D-D is the best choice. Key messages Taking into account the economic effect, the combination of CA19-9 and D-D can be chosen as an effective indicators to identify patients with spontaneously ruptured OE in pre-operation assessment. From the perspective of differential diagnosis, the combination of CA-125, CA19-9 and D-D is the best choice to identify patients with spontaneously ruptured OE.

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Prevalence of deep and ovarian endometriosis in early pregnancy: ultrasound diagnostic study

Cited by 14 publications

References 25 publications

Prevalence of endometriosis and adenomyosis at transvaginal ultrasound examination in symptomatic women

Prevalence of endometriosis and adenomyosis at transvaginal ultrasound examination in symptomatic women

Reproductive outcome in 326 women with unicornuate uterus

Extremely high serum CA19-9 level along with elevated D-dimer in assisting detection of ruptured ovarian endometriosis

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