Endometriosis is a common disease. In most cases, it is difficult to diagnose and is closely linked to infertility. Instituto Bernabeu understands this and its Endometriosis Unit aims to ensure earlier and more accurate diagnosis using the very latest techniques. These range from ground-breaking biochemical markers to analyses of the realistic images provided by three-dimensional ultrasounds.

Once a longed-for pregnancy has been achieved, is prenatal care any different in these cases?

An article was recently published on research carried out in France to check obstetric and perinatal results in pregnancies following assisted reproduction treatment in women previously diagnosed as having endometriosis. The results show that obstetric complications occur with greater frequency: bleeding during the first term, pre-eclampsia, a risk of premature birth and intrauterine growth restriction. Even the number of caesarian section births increase and all these symptoms are linked to the seriousness of the endometriosis prior to pregnancy.

In our opinion, the results are understandable and to be expected since the thickness of the uterus itself is often affected: so-called adenomyosis. This is a strain of endometriosis which is also difficult to diagnose and which is of great relevance because it can decrease the embryo’s ability to implant and later develop. In order to get a better understanding of this little-understood condition, three-dimensional ultrasound checks have become part of the routine in our Endometriosis Unit. We are also involved in several lines of research aimed at determining uterine implantation capacity depending on the seriousness of each case.

With the aforementioned in mind, the Pregnancy Unit at Instituto Bernabeu provides personalised and appropriate prenatal checks in pregnancies achieved following assisted reproduction treatment and, more specifically, in women with endometriosis. Many of these women are already under emotional stress because they have suffered for years from a condition with unpleasant symptoms, have gone through unsuccessful treatment and, quite possibly, surgery.

Once the patient has become pregnant, the pregnancy will necessarily be categorised as high-risk and will call for more frequent and detailed checks by specialised healthcare experts aiming to foresee the possible complications mentioned in the aforementioned article.

Dr Francisco Sellers, Director of the Medical Unit at Instituto Bernabeu

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Prenatal care following endometriosis
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