Unveiling Hidden Risks: Obstetrical Complications in Endometriosis Associated Infertility Post-Laparoscopic Surgery

Abstract

Objective This study aims to elucidate the spectrum of obstetrical complications in patients with endometriosis-associated infertility following complete laparoscopic excision of endometriosis lesions, and to assess the impact of endometriosis severity on these outcomes. Study design: This case-control study enrolled 151 women who underwent laparoscopic surgery for endometriosis-associated infertility at Fujian Maternity and Child Health Hospital between January 2014 and September 2020, and who subsequently gave birth to a singleton at the same hospital by September 2021. Participants were divided into a stage I–II endometriosis group (n = 88) and a stage III–IV endometriosis group (n = 63). A control group consisted of 302 women without endometriosis who delivered a singleton at the same hospital during the same period. Clinical data and complications during pregnancy, delivery, and the neonatal stages were collected from the hospital’s medical record system. Results After adjusting for confounding factors, women in the stage I–II endometriosis group had a significantly higher risk of gestational diabetes mellitus (GDM) (P = 0.004) and cesarean section (P = 0.027) compared to the control group. Women in the stage III–IV endometriosis group exhibited a higher risk of GDM (P = 0.048) and premature rupture of membranes (P = 0.039). No statistically significant differences were observed in other obstetrical complications between the endometriosis and control groups. Conclusions Women with a history of stage I–II endometriosis who have undergone laparoscopic conservative surgery face a higher risk of GDM and cesarean section during pregnancy. Those with a history of stage III–IV endometriosis are at an elevated risk of GDM and premature rupture of membranes. These findings underscore the need for heightened monitoring and management of pregnancies in women with prior endometriosis.