Impact of endometriosis in a pregnant woman

What is it about?

It is often thought that endometriosis remains quiescent in pregnancy due to the physiological suppression of oestrogen, however; higher levels of progesterone in pregnancy can cause decidualisation of ectopic endometrial tissue. Decidualisation and involution of endometriotic lesions around major vessels cause spontaneous haemoperitoneum in pregnancy SHiP which can cause severe maternal / fetus morbidity and mortality due to massive unrecognised blood loss in the abdomen which ultimately affects the blood supply to the baby and unfortunately can result in dying the baby inside the womb.

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Why is it important?

The general belief among the clinicians and the general public is that endometriosis can cause difficulty in getting pregnant in severe form but once a woman is pregnant endometriosis improves from a symptomology point of view and may not cause any risk to the mother or baby as such. However, this case clearly identifies that old endometriosis spots can cause sudden bleeding from main blood vessels resulting in massive blood loss. Luckily the number of mother of a baby dying due to this condition are low because it is very rare and secondly emergency management is available in developed countries but it needs awareness among clinicians that endometriosis can have potentially dangerous consequences in pregnancy

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