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Archives of Gynecology and Obstetrics
Published in: Archives of Gynecology and Obstetrics 1/2018

01-07-2018 | Review

Placenta previa and placental abruption after assisted reproductive technology in patients with endometriosis: a systematic review and meta-analysis

Authors: Maria Luisa Gasparri, Konstantinos Nirgianakis, Katayoun Taghavi, Andrea Papadia, Michael D Mueller

Published in: Archives of Gynecology and Obstetrics | Issue 1/2018

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Abstract

Introduction

Recent evidence suggests that assisted reproductive technology (ART) increases the risk of adverse pregnancy outcomes, including placental disorders. Similarly, endometriosis resulted detrimental on placenta previa. However, up to 50% of women with endometriosis suffer from infertility, thus requiring ART. The aim of our metanalysis is to compare women with and without endometriosis undergoing ART in terms of placenta disorders events, to establish if ART itself or endometriosis, as an indication to ART, increases the risk of placenta previa.

Methods

Literature searches were conducted in January 2018 using electronic databases (PubMed, Medline, Scopus, Embase, Science Direct, and the Cochrane Library Scopus). Series comparing pregnancy outcome after ART in women with and without endometriosis were screened and data on placenta previa and placental abruption were extracted.

Results

Five retrospective case–control studies met the inclusion criteria. The meta-analysis revealed that endometriosis is associated with an increased risk of placenta previa in pregnancies achieved through ART (OR 2.96 (95% CI 1.25–7.03); p = 0.01, I2 =69%, random-effect model). No differences in placental abruption incidence were found (OR 0.44 (95% CI 0.10–1.87); p = 0.26, I2 = 0%, fixed-effect model).

Conclusion

Patients with endometriosis undergoing ART may have additional risk of placenta previa. Despite the inability to determine if endometriosis alone or endometriosis plus ART increase the risk, physicians should be aware of the potential additional risk that endometriosis patients undergoing ART harbor.
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Metadata
Title
Placenta previa and placental abruption after assisted reproductive technology in patients with endometriosis: a systematic review and meta-analysis
Authors
Maria Luisa Gasparri
Konstantinos Nirgianakis
Katayoun Taghavi
Andrea Papadia
Michael D Mueller
Publication date
01-07-2018
Publisher
Springer Berlin Heidelberg
Published in
Archives of Gynecology and Obstetrics / Issue 1/2018
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-018-4765-x

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