The most important news first: Even with endometriosis during pregnancy, a completely uncomplicated and relaxed course is not only possible, it is even the norm. If you suffer from endometriosis and are expecting a child, you should still pay special attention to a few symptoms and signals from your body. We have compiled all the important information for you in a clear overview.
Symptoms of endometriosis: Many women are affected
Endometriosis is a serious and at the same time still underestimated disease. Every year, about 8 to 15 percent of women of childbearing age in Germany develop endometriosis – and the suffering has a major impact on their daily lives and their fertility.
This is because in this disease, altered cells that resemble the lining of the uterus settle outside the uterus. These are benign growths, so-called endometriosis foci, which are mainly found in the lower abdomen (adenomyosis). They cause severe pain and cramps, even independent of menstruation. In addition, endometriosis is accompanied by symptoms such as fatigue, lack of drive, and pain during sex.
Pregnant despite endometriosis: Finally, the desire for children comes true
Many affected women with pronounced endometriosis also have an unfulfilled desire for children. In 40 to 60 percent of women who are unintentionally childless, endometriosis is the cause. The reasons for possible infertility are diverse. Scarring in the fallopian tubes or ovaries, toxic influence on sperm and egg cells, changes in the uterine lining that impair the implantation of the embryo, or endocrine disorders that reduce the quality of ovulation.
Women with endometriosis therefore have a harder time getting pregnant naturally. However, it is by no means impossible. If you suffer from endometriosis, it may have been a long road to your pregnancy and you may have become pregnant through artificial insemination. But now you are expecting a child and may be wondering: What impact does my illness have on my pregnancy?
We can reassure you: Yes, there are some complications that can occur with endometriosis during pregnancy. But you don't need to drive yourself crazy. The norm is still that a pregnancy proceeds without complications even for women with endometriosis.
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Risk of complications with endometriosis during pregnancy? Regular check-ups are key!
Every pregnant woman should keep her appointments with the gynecologist or midwife. For pregnant patients with endometriosis, however, the check-ups might be a bit more frequent.
It is important that you let your treating physician know that you have endometriosis so that examinations are carried out with even greater care. This includes, for example, the ultrasound of the abdominal cavity.
We don't want to scare you: However, you should know the following possible (but rare) complications so that you and your doctor have everything in view – and you can fully enjoy your pregnancy despite endometriosis.
- Ectopic pregnancies: If you suffer from severe adhesions, the risk of an ectopic pregnancy is increased – up to three times higher than in healthy women.
- Miscarriages: Especially at the beginning of pregnancy with endometriosis, there is an increased risk of miscarriage. This is also confirmed by a large-scale British study. Here, data from over 14,000 women were collected and evaluated over a period of 30 years. Of these, 5,375 women suffered from endometriosis.
- Placenta Praevia: Placenta praevia refers to a malposition of the placenta. This can certainly happen with endometriosis during pregnancy, as the implantation of the placenta can be negatively influenced by the tissue growths.
- Abdominal pregnancy: An abdominal pregnancy occurs when the fallopian tube is leaking or the uterus is blocked. Then the egg cell can reach the abdominal cavity on its way from the ovary to the uterus. Precisely because placenta praevia can occur with endometriosis during pregnancy, the risk of an abdominal pregnancy is also increased.
- Birth canal injuries: Very rarely, complications can also occur during birth due to endometriosis. For example, birth injuries in the vaginal area are more common in endometriosis patients because the altered (scarred) tissue cannot stretch as well. One way to avoid these injuries would be a cesarean section, for example.
Other complications you should know (but not necessarily fear) are the following: bleeding during pregnancy, a rupture of the uterus, a breakthrough of the intestine into the abdominal cavity, or the rupture of cysts.
Pregnant despite endometriosis: don't panic!
The possible complications during pregnancy certainly sound frightening to you, but they should at least be mentioned in the context of endometriosis during pregnancy. But be aware: The complications mentioned only occur in rare cases.
Have yourself examined closely by your midwife or doctor. Should complications occur, they can be recognized and treated as early as possible. Therefore, try not to panic and stay as calm as possible. This benefits not only you but also your baby.
After endometriosis surgery: No complications during birth
Women with an unfulfilled desire for children can have their endometriosis removed as part of an operation. The growths are surgically removed, increasing the chances of pregnancy. If you also have an unfulfilled desire for children and are affected by endometriosis, you can ask your doctor about a possible operation.
Many women with endometriosis who have had their growths and foci surgically removed are often worried afterwards that they have an increased risk of complications during birth. But we can take away this concern.
Researchers at the University Clinic for Gynecology at the Inselspital in Bern have investigated this in a study. Women with endometriosis did have a slightly higher blood loss during birth, but otherwise there were no complications for mother or child. Spontaneous births were also almost as frequent as in the comparison group of women without endometriosis.
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