inflammatory bowel diseases Archives - Revista Brasileira de Ginecologia e Obstetrícia

  • Original Article

    Inflammatory Bowel Disease and Pregnancy: Is It a Marker for Adverse Outcomes?

    Rev Bras Ginecol Obstet. 2022;44(10):915-924

    Summary

    Original Article

    Inflammatory Bowel Disease and Pregnancy: Is It a Marker for Adverse Outcomes?

    Rev Bras Ginecol Obstet. 2022;44(10):915-924

    DOI 10.1055/s-0042-1756149

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    Abstract

    Objective

    To assess obstetric/puerperal/neonatal outcomes in an inflammatory bowel disease (IBD) population and to analyze disease characteristics that may be associated to adverse outcomes.

    Methods

    Retrospective descriptive analysis including 47 pregnant womn with IBD (28 with Crohn's disease – CD and 19 with ulcerative colitis – UC) who delivered between March 2012 and July 2018 in a tertiary hospital. We reviewed clinical records to extract demographic information, previous medical history, disease subtype, activity, severity, treatment, and obstetric, puerperal, and neonatal outcome measures.

    Results

    Obstetric and neonatal complications (composite outcomes) occurred in 55.3% and 14.6% of the IBD population, respectively, and were more frequent in UC patients. Preterm birth (PTB), preeclampsia, anemia, low birth weight (LBW), and neonatal death were also more frequent in UC patients. The rate of postpartum hemorrhage (PPH) was 14.9%, and it was higher in CD patients. Women with active IBD had more obstetric/neonatal adverse outcomes (fetal growth restriction and LBW in particular) and cesarean sections. Patients with medicated IBD had less obstetric/neonatal complications (PTB and LBW in specific) and cesarean sections but more PPH.

    Conclusion

    Women with IBD may have an increased risk of obstetric/puerperal/neonatal adverse outcomes. Ulcerative colitis patients had more obstetric and neonatal complications, whereas PPH was more frequent if CD patients. Other disease characteristics were considered, which allowed a better understanding of their possible influence. Although more research is needed, this work reinforces the importance of adequate surveillance to allow prompt recognition and treatment of complications.

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  • Original Article

    Association between ovarian endometrioma and deep infiltrating endometriosis

    Rev Bras Ginecol Obstet. 2012;34(9):420-424

    Summary

    Original Article

    Association between ovarian endometrioma and deep infiltrating endometriosis

    Rev Bras Ginecol Obstet. 2012;34(9):420-424

    DOI 10.1590/S0100-72032012000900006

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    PURPOSE: To evaluate the association between ovarian endometrioma and the presence of deep infiltrating endometriosis (DIE) lesions in a sample of women of the South of Brazil. METHODS: A retrospective study was conducted in all women undergoing surgical treatment of endometriosis from January 2010 to June 2012. Patients were divided into 2 groups according to the presence or not of ovarian endometrioma. Patients presenting an ovarian endometrioma were subsequently divided into 2 groups according to the diameter of the endometrioma (<40 and >40 mm). The following parameters were compared between the groups: cancer antigen (CA) 125 level, size of the endometrioma, presence and number of deep lesions. The statistical analysis was performed with Statistica version 8.0 using Fisher's exact test, Student's t-test and Mann-Whitney test, when needed. The p values of <0.05 were considered statistically significant. RESULTS: During the study period, a total of 201 women underwent laparoscopic surgical treatment of endometriosis. Fifty-five patients (27.9%) presented ovarian endometrioma and 180 patients (89.5%) presented DIE confirmed by pathologic examination. Women presenting an ovarian endometrioma had higher CA 125 levels (39.5 versus 24.1 U/mL; p<0.01) and stronger association with the presence of DIE lesions (98.2 versus 86.2%; p=0.01) and intestinal DIE (57.1 versus 37.9%; p=0.01). There was no difference between the groups with endometriomas <40 and >40 mm. CONCLUSIONS: Ovarian endometrioma is a marker for the presence of DIE lesions, including intestinal DIE.

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