Effects of adenomyosis on obstetric outcomes

INTRODUCTION: Several studies investigated the correlation between adenomyosis and adverse pregnancy outcomes. However, the role of adenomyosis as a risk factor for adverse outcomes has yet to be established. The aim of this systematic review is to clarify the possible association between uterine adenomyosis and poor obstetrical outcomes. EVIDENCE ACQUISITION: Numerous studies have demonstrated that adenomyosis increased miscarriage rate, preterm birth and preterm premature rupture of membranes. We conducted a systematic review on the effects of adenomyosis during pregnancy on obstetric outcomes. EVIDENCE SYNTHESIS: Four studies were included for qualitative analysis, we excluded the studies in which adenomyosis was associated to endometriosis. Overall, included studies showed that the patients with adenomyosis have an increased risk of some poor obstetrical outcomes, such as miscarriage, preterm birth, premature rupture of membrane, small gestational age, hypetensive disorders and malpresentation. CONCLUSIONS: The potential consequences of adenomyosis during pregnancy are difficult to evaluate because, now, there are few data available concerning adenomyosis and major obstetrical complications and because the study populations of those studies were small. Our results suggest that women with adenomyosis have needed of a prenatal management in a tertiary center.