Clinical characteristics and outcomes of women with adenomyosis pain during pregnancy: a retrospective study
Author:
Sayama Seisuke1, Iriyama Takayuki1, Takeiri Yotaro1, Hashimoto Ayako1, Toshimitsu Masatake1, Ichinose Mari1, Seyama Takahiro1, Sone Kenbun1, Kumasawa Keiichi1, Nagamatsu Takeshi12, Koga Kaori13, Osuga Yutaka1
Affiliation:
1. Department of Obstetrics and Gynecology, Faculty of Medicine , The University of Tokyo , Bunkyo-ku , Tokyo , Japan 2. Department of Obstetrics and Gynecology , International University of Health and Welfare , Narita-shi , Chiba , Japan 3. Department of Reproductive Medicine, Graduate of School of Medicine , Chiba University , Chiba-shi , Chiba , Japan
Abstract
Abstract
Objectives
Adenomyosis is associated with unfavorable perinatal outcomes, and recent case reports show that some women with adenomyosis experience pain at the adenomyosis lesion during pregnancy and have detrimental perinatal outcomes. This study aimed to clarify the clinical characteristics of this pain and perinatal outcomes associated with this phenomenon.
Methods
This was a single-center retrospective analysis of pregnant women with adenomyosis. The incidence of pain onset at adenomyosis lesions, defined as persistent pain at the adenomyosis site with administration of analgesics for pain relief, and its association with perinatal outcomes were analyzed.
Results
Among 91 singleton pregnancies with adenomyosis, 12 pregnancies (13.2 %) presented with pain. One pregnancy resulted in second-trimester miscarriage, and 5 of the 11 pregnancies (45 %) developed preeclampsia, which resulted in preterm delivery, and 3 of the 12 pregnancies (25 %) achieved term delivery. The incidence of preeclampsia and preterm delivery was higher in those who experienced pain than in those without (45 % [5/11] vs. 15 % [11/74]; p<0.05, and 73 % [8/11] vs. 34 % [25/74]; p<0.05, respectively). Among women with pain, the maximum C-reactive protein level was significantly higher in women who developed preeclampsia than in those who did not (5.45 vs. 0.12 mg/dL, p<0.05).
Conclusions
Our study revealed that adenomyosis can cause pain in over one of eight pregnancies with adenomyosis, which may be associated with the increased incidence of preeclampsia resulting in preterm delivery. Women with pain, especially those with high C-reactive protein levels, may be at high risk for future development of preeclampsia and consequent preterm delivery.
Publisher
Walter de Gruyter GmbH
Subject
Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health
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