Endometriosis and pregnancy: risks and what to do

Endometriosis in pregnancy is a situation that can directly interfere with the development of pregnancy, especially if it is a deep endometriosis.

It is important that pregnant women with endometriosis are regularly monitored by the obstetrician-gynecologist to prevent complications.

The main risks of endometriosis in pregnancy are:

• Higher probability of miscarriage;
• Premature birth;
• Increased risk of rupture of the veins that supply the uterus;
• Possibility of complications related to the placenta;
• Higher risk of eclampsia;
• Need a cesarean;
• Increased chance of ectopic pregnancy, which is when pregnancy takes place outside the uterus.

Endometriosis is a condition in which the tissue that lines the uterus, called the endometrium, grows in other places in the abdomen, such as the ovaries, bladder or intestine, causing symptoms such as severe pelvic pain, heavy menstruation and, in some cases, infertility. Learn more about endometriosis.

What to do

It is important that the woman is followed up regularly by the doctor, as it is possible for the doctor to check for risks and thus be able to recommend the best treatment. In most cases, no specific treatment is necessary, and symptoms improve, in some cases, towards the end of pregnancy. Surgery for endometriosis is only indicated when there is a risk of death for the mother or baby.

Although in some cases the woman has an improvement in symptoms throughout pregnancy, others may experience a worsening of symptoms particularly during the first few months.

improvement of symptoms

It is not known for sure what causes this improvement, but it is believed that the beneficial effects are due to the high levels of progesterone that are produced during pregnancy, which contributes to the reduction of the growth and development of endometriosis lesions, making them less active. The beneficial effects may also be related to the absence of menstruation during the gestation period.

For women who experience improvement from endometriosis during pregnancy, it is good to know that these beneficial effects are only temporary, and that endometriosis symptoms may return after pregnancy. However, during breastfeeding there may also be a decrease in symptoms as it inhibits the release of estrogen from the ovaries, thus suppressing ovulation and the growth and development of endometriosis.

worsening of symptoms

On the other hand, the worsening of symptoms in the first few months may be due to the rapid growth of the uterus, which can cause tissue damage to tighten, or to high levels of estrogen, which can also worsen symptoms.

Does endometriosis make pregnancy difficult?

In some cases, endometriosis can make pregnancy difficult, particularly when endometrial tissue attaches to the fallopian tubes and prevents the mature egg from passing into the uterus, preventing conception. However, there are reports of several women who managed to conceive naturally despite having endometriosis, as their ovaries and fallopian tubes were not affected by the disease and their fertility was preserved.

However, some women who suffer from endometriosis need to stimulate ovulation with treatments in order to get pregnant. See more information about getting pregnant with endometriosis.

Watch the video with Dr. Helizabet Ribeiro, a gynecologist specializing in endometriosis who clarifies all doubts about this disease: